Individual provider Active NPI

Mena Magdi Zaki Mansour, MD

  • Anatomic Pathology Physician
  • Houston, TX
National Provider Identifier
1144562125
Registry record updated Jan 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
V4705 Issued in TX
Practice address
1515 Holcombe Blvd
Houston, TX 77030-4000
Phone
(713) 792-6161
Fax
(314) 362-0369
NPI assigned
Mar 18, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X 2018025131 MO
Anatomic Pathology Physician 207ZP0101X V4705 TX Primary

Addresses

Primary practice location

1515 Holcombe Blvd
Houston, TX 77030-4000

Mailing address

PO Box 4439
Houston, TX 77210-4439
Phone (713) 792-2991

Other identifiers 1

IdentifierTypeStateIssuer
200057119MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL, TX3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20180808002601 MO Practitioner - Pathology 9133413990 Reassigns benefits to 1 organization
I20240214003834 IL Practitioner - Pathology 9133413990 Reassigns benefits to 1 organization
I20250114003783 TX Practitioner - Pathology 9133413990 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians Referral ServiceGroup PAC ID 7911801410, 2,728 clinicians

Practice addresses (Care Compare)

1515 Holcombe Blvd
Houston, TX 77030-4000
Phone (713) 792-6313

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.2 of 100Reported as group
Quality
71.6
Promoting interoperability
100
Improvement activities
40
Cost
75.75

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2018025131MOMDAnatomic Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Washington University CurrentSince Jul 16, 2018 Accepting new patients
Washington University CurrentSince Jul 16, 2018 Accepting new patients
Washington University Physicians in Illinois, Inc. CurrentSince Jan 1, 2024 Accepting new patients
Physicians Referral Service CurrentSince Dec 17, 2024 Accepting new patients
Washington University Physicians in Illinois, Inc CurrentSince Jan 1, 2024 Accepting new patients
Washington University Physicians in Illinois, Inc Current Accepting new patients

Locations

1404 Cross St
Shiloh, IL 62269
Phone (618) 607-1000

4500 Memorial Dr
Swansea, IL 62226
Phone (618) 233-7750

1 Barnes Jewish Hospital Plz
#P
Saint Louis, MO 63110
Phone (618) 474-1074

1 Barnes Jewish Hospital Plz
Fl 3
Saint Louis, MO 63110

1 Barnes Hospital Plz
Saint Louis, MO 63110
Phone (314) 362-9170

660 S Euclid Ave
#8118
Saint Louis, MO 63110
Phone (314) 362-0101

1515 Holcombe Blvd
#M
Houston, TX 77030
Phone (713) 792-6127

1515 Holcombe Blvd
#R4212
Houston, TX 77030
Phone (713) 794-5446

1515 Holcombe Blvd
Houston, TX 77030
Phone (713) 794-5446

Organizations & group practices 6

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 1

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": "1363564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1144562125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4439",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772104439",
            "telephone_number": "713-792-2991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 HOLCOMBE BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304000",
            "telephone_number": "713-792-6161",
            "fax_number": "314-362-0369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOUR",
        "first_name": "MENA",
        "middle_name": "MAGDI ZAKI",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-18",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "MO",
            "license": "2018025131",
            "primary": false
        },
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "TX",
            "license": "V4705",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200057119",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.