Mariela Celeste Ventocilla

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

010127041 Issued in VA

Practice address

1145 Sturgis Road
Twentynine Palms, CA 92277

Phone

(916) 734-2356

NPI assigned

Mar 31, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

University of California, Davis School of Medicine, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southern California Permanente Medical GroupGroup PAC ID 6002729175, 11,250 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Hi-Desert Medical Center Hospital, Joshua Tree, CA, CCN 050279

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Riverside, CA
  • NPI 1316979834
  Medicare reassignment Care Compare group

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• HDMC Holdings, LLC

  • General Acute Care Hospital
  • Joshua Tree, CA
  • NPI 1851787295
  Care Compare affiliation

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

{
    "created_epoch": "1364688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1972846756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3101 UPSHUR AVE APT C",
            "city": "TWENTYNINE PALMS",
            "state": "CA",
            "postal_code": "922779482",
            "telephone_number": "408-458-0132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1145 STURGIS ROAD",
            "city": "TWENTYNINE PALMS",
            "state": "CA",
            "postal_code": "92277",
            "telephone_number": "916-734-2356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VENTOCILLA",
        "first_name": "MARIELA",
        "middle_name": "CELESTE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-31",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "VA",
            "license": "010127041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LISCENCE NUMBER",
            "identifier": "010127041",
            "state": "VA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.tricare.mil/Military-Hospitals-and-Clinics/Types-of-Military-Facilities/SecurePatientPortal",
            "affiliation": "N",
            "endpointDescription": "direct patient portal to messages",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "call clinic 760-830-2621",
            "address_1": "1660 Griffin Road",
            "address_2": "AMCC",
            "city": "Twentynine Palms",
            "state": "CA",
            "country_code": "US",
            "postal_code": "92278",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Britney Kay Vachon-Laguardia, LCSW, AASW
• Louis Edward Valbracht, D.O., MPH
• Brittany Van Nielen, DPT
• Michael D Vanmanen, DO
• George Ramirez Velasquez, INDEPENDENT DUTY HM
• Margaret P Ventris, PTA
• John Anthony Vigilante IV, M.D.
• Sungchun Steven Wee, D.D.S.
• Therese Marie Weseman, REGISTERED NURSE
• Tammy Lynn Weston

• Adult Medicine Physician in Twentynine Palms, CA
• Providers in Twentynine Palms, CA by specialty
• Adult Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 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.