Individual provider Active NPI

Mansoor Ahmed Sajid, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Fort Myers, FL
National Provider Identifier
1114168689
Registry record updated May 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
ME119814 Issued in FL
Practice address
2848 Center Pointe Dr Ste a
Fort Myers, FL 33916-9521
Phone
(239) 561-9622
Fax
(239) 768-5297
NPI assigned
Mar 13, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 3, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 6779059-1205 UT
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X M8309 TX
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X ME119814 FL Primary

Addresses

Primary practice location

2848 Center Pointe Dr Ste a
Fort Myers, FL 33916-9521

Mailing address

19006 Wildblue Blvd
Fort Myers, FL 33913-8752
Phone (713) 398-0332

Other identifiers 1

IdentifierTypeStateIssuer
106007100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20151110002952 TX Practitioner - Pathology 1658694005

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

18181 SW 83Rd CT
Palmetto Bay, FL 33157-6176

P O Box
1017 BPS Managed Care
Greenville, TX 75403-1017

PO Box
Suite 745390
Atlanta, GA 30374-5390

Hospital & facility affiliations

  • Medical City Dallas Hospital Hospital, Dallas, TX, CCN 450647
  • Medical City Fort Worth Hospital, Fort Worth, TX, CCN 450672

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
108018CAMDGeneral Practice Dentistry
6779059-1205UTMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Oncology Partners, P.a. PastSince Sep 15, 2024 Accepting new patients
Pathologists Biomedical Laboratories PLLC Anatomic Pathology & Clinical Pathology PastSince Sep 30, 2015 Accepting new patients
Pathologists Bio-Medical Laboratories PLLC Anatomic Pathology & Clinical Pathology Past Accepting new patients

Organizations & group practices 3

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1236902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651536000000",
    "number": "1114168689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19006 WILDBLUE BLVD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339138752",
            "telephone_number": "713-398-0332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2848 CENTER POINTE DR STE A",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339169521",
            "telephone_number": "239-561-9622",
            "fax_number": "239-768-5297"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAJID",
        "first_name": "MANSOOR",
        "middle_name": "AHMED",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-13",
        "last_updated": "2022-05-03",
        "certification_date": "2022-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "UT",
            "license": "6779059-1205",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "TX",
            "license": "M8309",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "ME119814",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "106007100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Myers, FL

Sources for this page

Verify at the official NPI Registry.