Dominador Peralta Mansat Jr., FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

95022872 Issued in CA

Practice address

1910 S Archibald Ave Ste D
Ontario, CA 91761-8503

Phone

(909) 348-2556

Fax

(877) 615-1555

NPI assigned

Oct 4, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Care First Mobile Medical Group IncGroup PAC ID 9335597772, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

17.68 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

58.94

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Care First Mobile Medical Group Inc

  • Primary Care Nurse Practitioner
  • San Diego, CA
  • NPI 1538871678
  Medicare reassignment Care Compare group NPD
• Dominador Mansat Jr, a Professional Nursing Corp

  • Family Nurse Practitioner
  • Ontario, CA
  • NPI 1972298180
  NPD Authorized official
• Aarb Medical & Healthcare Services Inc

  • Health Service Clinic/Center
  • Ontario, CA
  • NPI 1952023897
  NPD
• Heidi Regenass, M.D., PC.

  • Plastic Surgery Physician
  • Santa Ana, CA
  • NPI 1730826223
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1664841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664841600000",
    "number": "1700500600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9415 RETREAT PL",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917309200",
            "telephone_number": "909-348-3067",
            "fax_number": "877-615-1555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 S ARCHIBALD AVE STE D",
            "city": "ONTARIO",
            "state": "CA",
            "postal_code": "917618503",
            "telephone_number": "909-348-2556",
            "fax_number": "877-615-1555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSAT",
        "first_name": "DOMINADOR",
        "middle_name": "PERALTA",
        "name_suffix": "Jr.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-04",
        "last_updated": "2022-10-04",
        "certification_date": "2022-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95022872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evelyn Mancillas-Estrada
• Kailen Mangu
• Manila Non- Medical Transportation Inc
• Allan Manio, PHARMD
• Manouchehri & Rodef Dental Corporation
• Johnny Mansour, D.C.
• Rosemary Mantele
• Manuel G. Figueroa D.D.S., Inc.
• Colleen Melinda Manus
• Cathleen Womble Manusia, FNP

• Family Nurse Practitioner in Ontario, CA
• Providers in Ontario, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.