Active NPI
Yousif S. Mansour, M.D.
- Internal Medicine Physician
- Southfield, MI
National Provider Identifier
1154330355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- YMO44148
- Practice address
- 17070 W 12 Mile Rd
Suite a
Southfield, MI 48076-2116 - Phone
- (248) 559-2280
- Fax
- (248) 559-3752
- NPI assigned
- Aug 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | YMO44148 | MI | Primary |
Addresses
Primary practice location
17070 W 12 Mile Rd
Suite a
Southfield, MI 48076-2116
Mailing address
17070 W 12 Mile Rd
Ste a
Southfield, MI 48076-2116
Phone (248) 559-2280
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2630979 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| YMO44148 | MI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lima Memorial Joint Operating Company | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Acute Care Hospital
- Lima, OH
- NPI 1336144732
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472515200000",
"number": "1154330355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17070 W 12 MILE RD",
"address_2": "STE A",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480762116",
"telephone_number": "248-559-2280",
"fax_number": "248-559-3752"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17070 W 12 MILE RD",
"address_2": "SUITE A",
"city": "SOUTHFIELD",
"state": "MI",
"postal_code": "480762116",
"telephone_number": "248-559-2280",
"fax_number": "248-559-3752"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANSOUR",
"first_name": "YOUSIF",
"middle_name": "S.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-05",
"last_updated": "2016-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "YMO44148",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2630979",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Southfield, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.