Organization Active NPI

Dr. Rumana Mansur and Associates, a Professional Psychological Corpora

  • Clinical Psychologist
  • Newport Beach, CA
National Provider Identifier
1174021729
Registry record updated Nov 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
Legal business name
DR. RUMANA MANSUR AND ASSOCIATES, A PROFESSIONAL PSYCHOLOGICAL CORPORA
Practice address
4000 Macarthur Blvd Ste 600
Newport Beach, CA 92660-2517
Phone
(657) 223-3360
NPI assigned
Jan 29, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2022

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

Authorized official

Name
Dr. Rumana Mansur, PHDNPI 1558523738
Title
President/ Owner
Phone
(657) 223-3360

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X CA Primary

Addresses

Primary practice location

4000 Macarthur Blvd Ste 600
Newport Beach, CA 92660-2517

Mailing address

4000 Macarthur Blvd Ste 600
East Tower
Newport Beach, CA 92660-2517

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180503002283 CA Part B Supplier - Clinic/Group Practice 9032473798 Receives reassigned benefits from 2 practitioners
Practice locations: Newport Beach, CA

National Provider Directory

National Provider Directory

Locations

180 Newport Center Dr
Ste 270D
Newport Beach, CA 92660
Phone (657) 223-3360

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1517184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667779200000",
    "number": "1174021729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 MACARTHUR BLVD STE 600",
            "address_2": "EAST TOWER",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 MACARTHUR BLVD STE 600",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602517",
            "telephone_number": "657-223-3360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. RUMANA MANSUR AND ASSOCIATES, A PROFESSIONAL PSYCHOLOGICAL CORPORA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-29",
        "last_updated": "2022-11-07",
        "certification_date": "2022-11-06",
        "status": "A",
        "authorized_official_last_name": "MANSUR",
        "authorized_official_first_name": "RUMANA",
        "authorized_official_title_or_position": "PRESIDENT/ OWNER",
        "authorized_official_telephone_number": "657-223-3360",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.