Benjamin Morales Manacop III

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95030284 Issued in CA

Practice address

1007 E Cooley Dr Ste 103
Colton, CA 92324-3901

Phone

(951) 727-6460

Fax

(909) 219-5336

NPI assigned

Jan 11, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Psychiatric/Mental Health

  Medicare reassignment NPD
• M Healthcare Nursing Corp

  • Primary Care Nurse Practitioner
  • Colton, CA
  • NPI 1225848823

  Psychiatric/Mental Health

  Medicare reassignment NPD
• Renewing Hope Family Counseling Center, Inc

  • Marriage & Family Therapist
  • Murrieta, CA
  • NPI 1235649260
  NPD (past)

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

{
    "created_epoch": "1704931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768176000000",
    "number": "1750152344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1007 E COOLEY DR STE 103",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923243901",
            "telephone_number": "951-727-6460",
            "fax_number": "909-219-5336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 E COOLEY DR STE 103",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923243901",
            "telephone_number": "951-727-6460",
            "fax_number": "909-219-5336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANACOP",
        "first_name": "BENJAMIN",
        "middle_name": "MORALES",
        "name_suffix": "III",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-11",
        "last_updated": "2026-01-12",
        "certification_date": "2026-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95030284",
            "primary": true
        },
        {
            "code": "163WX0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Oncology",
            "state": "CA",
            "license": "631790",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anil D Mall, M.D.
• Claire Elizabeth Malley, MD
• Mallu Reddy, MD, Inc
• Jessica Lee Malstrom
• Marko Michael Mamic, D.O.
• Amir Manafi, MD
• Sharan Kaur Mangat
• Navdeep Singh Manhas
• Jeannette Maniago
• Thomas Manning, P.A-C

• Psychiatric/Mental Health Nurse Practitioner in Colton, CA
• Providers in Colton, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2026; 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.