Individual provider Active NPI

Ayman Mohammed Omar Mansour, M.D.

  • Pediatrics Physician
  • Roanoke, VA
National Provider Identifier
1124223722
Registry record updated Sep 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0101287607 Issued in VA
Practice address
1906 Belleview Ave SE
Roanoke, VA 24014-1838
Phone
(540) 224-4635
NPI assigned
Jun 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0101287607 VA Primary
Pediatrics Physician 208000000X 2026-01673 NC
Pediatrics Physician 208000000X 25MA08360200 NJ
Pediatrics Physician 208000000X MD448187 PA

Addresses

Primary practice location

1906 Belleview Ave SE
Roanoke, VA 24014-1838

Mailing address

213 S Jefferson St Ste 1006
Roanoke, VA 24011-1713

Other practice location 1

100 Madison Ave
Morristown, NJ 07960-6136
Phone (973) 971-7550

Other practice location 2

40 Mayfair Ct
Brick, NJ 08723-6361
Phone (609) 495-4826

Other practice location 3

1638 Owen Dr
Fayetteville, NC 28304-3424
Phone (910) 615-4000

Other practice location 4

501 S Poplar St
Elizabethtown, NC 28337-9375
Phone (910) 672-0350

Other practice location 5

300A E McKay St
Elizabethtown, NC 28337-9037
Phone (910) 862-5500

Other practice location 6

100 Madison Ave
Morristown, NJ 07960-6136
Phone (973) 971-7550

Other practice location 7

111 S Front St
Harrisburg, PA 17101-2010
Phone (717) 231-8772

Other practice location 8

6311 Richmond Hwy
Alexandria, VA 22306-6410
Phone (703) 647-6087

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address amansour247223@phsdirect.pinnaclehealth.org
Direct Messaging Address VAExhcange@patientfirst.com Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA, DC, VA, NC5 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 5

Enrollment IDStateProvider typePAC IDDetails
I20121203000538 NJ Practitioner - Emergency MedicinePractitioner - Pediatric Medicine 6709038409 Reassigns benefits to 2 organizations
I20130408000091 PA Practitioner - Emergency Medicine 6709038409 Reassigns benefits to 1 organization
I20251230003705 DC Practitioner - Pediatric Medicine 6709038409 Reassigns benefits to 1 organization
I20260102001312 VA Practitioner - Pediatric Medicine 6709038409 Reassigns benefits to 2 organizations
I20260618003110 NC Practitioner - Pediatric Medicine 6709038409 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6311 Richmond Hwy
Alexandria, VA 22306-6410
Phone (703) 647-6087

9715 Liberia Ave
Manassas, VA 20110-5837
Phone (571) 229-1797

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2026-01673NCMDPediatrics Physician
0101287607VAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakewood Resource and Referral Center Inc CurrentSince Oct 16, 2012 Accepting new patients
Pinnacle Health Medical Services CurrentSince May 24, 2023 Accepting new patients
Patient First Richmond Medical Group PLLC CurrentSince Nov 17, 2025 Accepting new patients
Pinnacle Health Medical Services Pediatrics CurrentSince May 24, 2023 Accepting new patients
Carilion Medical Center CurrentSince Dec 19, 2025 Accepting new patients
Patient First Richmond Medical Group PLLC CurrentSince Nov 17, 2025 Accepting new patients
Carilion Medical Center CurrentSince Dec 19, 2025 Accepting new patients
Pinnacle Health Medical Services Pediatrics Current Accepting new patients
Lakewood Resource and Referral Center, Inc. CurrentSince Oct 16, 2012 Accepting new patients
Upmc Pinnacle Hospitals Past Accepting new patients
Carilion Medical Center Past Accepting new patients
Emergency Care Services of Pennsylvania, P.C. Past Accepting new patients
Riverside Medical Group PastSince Feb 1, 2022 Accepting new patients
Emergency Care Services of Pennsylvania, P.C. Past Accepting new patients

Locations

1771 Madison Ave
Lakewood, NJ 08701
Phone (732) 364-2144

111 S Front St
Harrisburg, PA 17101
Phone (717) 782-3282

2501 N 3rd St
Fl 2
Harrisburg, PA 17110
Phone (717) 782-2100

6311 Richmond Hwy
Alexandria, VA 22306
Phone (703) 647-6087

601 Potomac Station Dr NE
Leesburg, VA 20176
Phone (703) 840-1396

9715 Liberia Ave
Manassas, VA 20110
Phone (571) 229-1797

2017 Jefferson St SW
Roanoke, VA 24014
Phone (540) 981-7128

1906 Belleview Ave SE
Roanoke, VA 24014
Phone (540) 853-0222

213 S Jefferson St
Ste 1006
Roanoke, VA 24011
Phone (540) 224-5353

Interoperability endpoints

  • Direct secure messaging: amansour295340@upmc.direct-ci.com
  • Direct secure messaging: vaexhcange@patientfirst.com

Organizations & group practices 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1124223722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 S JEFFERSON ST STE 1006",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240111713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 BELLEVIEW AVE SE",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141838",
            "telephone_number": "540-224-4635"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 Madison Ave",
            "address_purpose": "LOCATION",
            "city": "Morristown",
            "state": "NJ",
            "postal_code": "079606136",
            "country_code": "US",
            "telephone_number": "973-971-7550",
            "fax_number": "973-290-2388",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "40 Mayfair Ct",
            "address_purpose": "LOCATION",
            "city": "Brick",
            "state": "NJ",
            "postal_code": "087236361",
            "country_code": "US",
            "telephone_number": "609-495-4826",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1638 Owen Dr",
            "address_purpose": "LOCATION",
            "city": "Fayetteville",
            "state": "NC",
            "postal_code": "283043424",
            "country_code": "US",
            "telephone_number": "910-615-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "501 S Poplar St",
            "address_purpose": "LOCATION",
            "city": "Elizabethtown",
            "state": "NC",
            "postal_code": "283379375",
            "country_code": "US",
            "telephone_number": "910-672-0350",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300A E McKay St",
            "address_purpose": "LOCATION",
            "city": "Elizabethtown",
            "state": "NC",
            "postal_code": "283379037",
            "country_code": "US",
            "telephone_number": "910-862-5500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Madison Ave",
            "address_purpose": "LOCATION",
            "city": "Morristown",
            "state": "NJ",
            "postal_code": "079606136",
            "country_code": "US",
            "telephone_number": "973-971-7550",
            "fax_number": "973-290-2388",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "111 S Front St",
            "address_purpose": "LOCATION",
            "city": "Harrisburg",
            "state": "PA",
            "postal_code": "171012010",
            "country_code": "US",
            "telephone_number": "717-231-8772",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6311 Richmond Hwy",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223066410",
            "country_code": "US",
            "telephone_number": "703-647-6087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANSOUR",
        "first_name": "AYMAN",
        "middle_name": "MOHAMMED OMAR",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-15",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101287607",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NC",
            "license": "2026-01673",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA08360200",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "PA",
            "license": "MD448187",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amansour247223@phsdirect.pinnaclehealth.org",
            "affiliation": "N",
            "address_1": "111 S Front St",
            "city": "Harrisburg",
            "state": "PA",
            "country_code": "US",
            "postal_code": "171012010",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "VAExhcange@patientfirst.com",
            "affiliation": "N",
            "endpointDescription": "emiail",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "6311 Richmond Hwy",
            "city": "Alexandria",
            "state": "VA",
            "country_code": "US",
            "postal_code": "223066410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Roanoke, VA

Sources for this page

Verify at the official NPI Registry.