Individual provider Active NPI

Samrah Mansoor, MD

  • Family Medicine Physician
  • Wichita, KS
National Provider Identifier
1063581809
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
04-31546 Issued in KS
Practice address
3161 N Rock Rd
Suite C
Wichita, KS 67226-1312
Phone
(316) 440-2713
Fax
(316) 260-6897
NPI assigned
Nov 7, 2006
Last updated
Mar 24, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 04-31546 KS Primary

Addresses

Primary practice location

3161 N Rock Rd
Suite C
Wichita, KS 67226-1312

Mailing address

3161 N Rock Rd
Suite C
Wichita, KS 67226-1312
Phone (316) 440-2713

Other practice location 1

27522 Antonio Pkwy Ste P3
Ladera Ranch, CA 92694-2166
Phone (949) 207-3786

Other practice location 2

1711 W Katella Ave
Anaheim, CA 92804-6450
Phone (714) 400-2959

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS, NE, CA4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20070613000038 MO Practitioner - Family Practice 4981702008 Reassigns benefits to 1 organization
I20140327002075 KS Practitioner - Family Practice 4981702008 Reassigns benefits to 2 organizations
I20230515003052 NE Practitioner - Family Practice 4981702008 Reassigns benefits to 1 organization
I20250630004290 CA Practitioner - Family Practice 4981702008 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maria Medical Group LLCGroup PAC ID 5991936403, 15 clinicians

Practice addresses (Care Compare)

3161 N Rock Rd
Suite B
Wichita, KS 67226-1453
Phone (316) 978-0287

3161 N Rock Rd a
Afc Doctors Express
Wichita, KS 67226-1312
Phone (316) 440-2712

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
04-31546KSMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Maria Medical Group, LLC CurrentSince Jan 1, 2014 Accepting new patients
Sun Medical Group, Inc Family Medicine CurrentSince Apr 1, 2025 Accepting new patients
Sun Medical Group, Inc. Family Medicine CurrentSince Apr 1, 2025 Accepting new patients
VWB LLC Family Medicine CurrentSince Apr 2, 2023 Accepting new patients
Med Ped Clinic of Wichita PA Family Medicine Current Accepting new patients
Premier Urgent Care/Family Care of Nebraska LLC CurrentSince Apr 2, 2023 Accepting new patients
Allmo Collective LLC Family Medicine CurrentSince Dec 1, 2023 Accepting new patients
Neurology Consultants of Kansas LLC PastSince Jul 18, 2022 Accepting new patients
Ozarks Medical Center Family Medicine Past Accepting new patients

Locations

1711 W Katella Ave
Anaheim, CA 92804
Phone (714) 337-9393

27522 Antonio Pkwy
Ste P3
Ladera Ranch, CA 92694
Phone (949) 207-3786

301 N Pagosa Blvd
Unit B10
Pagosa Springs, CO 81147

3161 N Rock Rd
Wichita, KS 67226
Phone (316) 440-2712

3161 N Rock Rd
Ste A
Wichita, KS 67226
Phone (316) 440-2712

3161 N Rock Rd
Ste B
Wichita, KS 67226
Phone (316) 978-0287

3161 N Rock Rd
Ste C
Wichita, KS 67226
Phone (316) 440-2713

9415 E Harry St
Ste 202
Wichita, KS 67207
Phone (316) 691-0309

320 Geneva Ave
Ste 100
Joplin, MO 64801
Phone (970) 264-5991

4004 N 132nd St
Ste 101
Omaha, NE 68164
Phone (402) 302-2273

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EBAGDD/Endpoint/EBAGDD
  • FHIR API: https://fhir4.healow.com/fhir/r4/FJHFCD

Organizations & group practices 10

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

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774310400000",
    "number": "1063581809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3161 N ROCK RD",
            "address_2": "SUITE C",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672261312",
            "telephone_number": "316-440-2713",
            "fax_number": "316-260-6897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3161 N ROCK RD",
            "address_2": "SUITE C",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672261312",
            "telephone_number": "316-440-2713",
            "fax_number": "316-260-6897"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27522 Antonio Pkwy Ste P3",
            "address_purpose": "LOCATION",
            "city": "Ladera Ranch",
            "state": "CA",
            "postal_code": "926942166",
            "country_code": "US",
            "telephone_number": "949-207-3786",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1711 W Katella Ave",
            "address_purpose": "LOCATION",
            "city": "Anaheim",
            "state": "CA",
            "postal_code": "928046450",
            "country_code": "US",
            "telephone_number": "714-400-2959",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANSOOR",
        "first_name": "SAMRAH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KS",
            "license": "04-31546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

Verify at the official NPI Registry.