Mohamed Mansour

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

191343 Issued in NY

Practice address

2912 210TH PL
Bayside, NY 11360-2433

Phone

(718) 773-2011

Fax

(718) 773-3728

NPI assigned

Jul 6, 2006

Sex

Male

Sole proprietor

Yes

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 NY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Interfaith Professional Physician Services, P.C.

  • Allergy Physician
  • Brooklyn, NY
  • NPI 1457643991
  Medicare reassignment NPD
• Interfaith Emergency Medicine, P.C.

  • Emergency Medicine Physician
  • Brooklyn, NY
  • NPI 1457643785
  NPD
• Park Place Medical P.C.

  • Gastroenterology Physician
  • Bayside, NY
  • NPI 1932389731
  NPD (past)

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222819200000",
    "number": "1003848854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2912 210TH PL",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113602433",
            "telephone_number": "718-773-2011",
            "fax_number": "718-773-3728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2912 210TH PL",
            "city": "BAYSIDE",
            "state": "NY",
            "postal_code": "113602433",
            "telephone_number": "718-773-2011",
            "fax_number": "718-773-3728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOUR",
        "first_name": "MOHAMED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2008-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NY",
            "license": "191343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alice Mangru
• Jack Michael Mann, M.D.
• Marina Manniello, PHARM.D
• Christina Manolatos
• Eftyhia Manolatos, OTR/L
• Giovanna Manzione
• Phyllis Maran
• Kimberly Maranino
• Marathon Infants & Toddlers
• Marathon Infants & Toddlers, Inc.

• Gastroenterology Physician in Bayside, NY
• Providers in Bayside, NY by specialty
• Gastroenterology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.