Mansoor Ahmad, M.D
Individual provider Active NPI Cardiovascular Disease Physician · Peoria, IL
NPI 1194059600 · NPPES record last updated Feb 22, 2024
Key facts
- NPI
- 1194059600
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Cardiovascular Disease Physician 207RC0000X
- License
- 036.128536 (IL)
- Practice address
- 112 NE Crescent Ave
Peoria, IL 61606-1901 - Phone
- (309) 672-4670
- Fax
- (309) 672-4669
- NPI assigned
- Sep 30, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 13
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- Other, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Carle Health Care Incorporated
Methodist Medical Center of Illinois
Proctor Health Systems
Practice addresses (Care Compare)
112 NE Crescent Ave
Peoria, IL 61606-1901
Phone (309) 672-4670
1120 E War Memorial Dr
Peoria, IL 61616-7757
Phone (309) 685-4411
1201 N Cummings LN
Washington, IL 61571-9267
Phone (309) 444-2090
1302 N Greenwood St
Spring Valley, IL 61362-1576
Phone (779) 323-8150
158 E Fulton St
Farmington, IL 61531-1227
Phone (309) 245-2416
1909 N Morton Ave
Morton, IL 61550-1426
Phone (309) 263-4343
201 N Cummings LN
Washington, IL 61571-2181
Phone (309) 444-3627
205 N Cummings LN
Suite B
Washington, IL 61571-2181
Phone (309) 691-6610
2076 N Main St
Canton, IL 61520-1054
Phone (309) 674-6090
209 N Cummings LN
Washington, IL 61571-2181
Phone (309) 643-6185
221 NE Glen Oak Ave
Peoria, IL 61636-0001
2338 W Van Winkle Way
FL 3
Peoria, IL 61615-7483
Phone (309) 693-2020
2338 W Van Winkle Way
Suite 1100
Peoria, IL 61615-7401
Phone (309) 672-4670
2338 W Van Winkle Way
Suite 3300
Peoria, IL 61615-7485
Phone (309) 693-2020
2535 E Washington St
East Peoria, IL 61611-1863
Phone (309) 694-6464
3335 N Sterling Ave
Peoria, IL 61604-1837
Phone (309) 687-5900
3591 Griffin Ave
Pekin, IL 61554-6258
528 Edward St
Henry, IL 61537-1218
Phone (779) 323-8150
5401 N Knoxville Ave
Peoria, IL 61614-5021
5409 N Knoxville Ave
Peoria, IL 61614-5069
Phone (309) 691-1000
600 S 13TH St
Pekin, IL 61554-4936
611 W Park St
Urbana, IL 61801-2501
Phone (888) 712-2753
6831 N Peartree LN
Peoria, IL 61615-2472
Phone (309) 691-1250
815 Main St
Suite a
Peoria, IL 61602-1080
Phone (309) 672-4977
8914 N Knoxville Ave
Peoria, IL 61615-1410
Phone (309) 691-9110
Hospital & facility affiliations
- Carle Health Methodist Hospital
- Carle Health Pekin Hospital
- Carle Health Proctor Hospital
- Saint Francis Medical Center
- Carle Foundation Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130201000119 | IL | Practitioner - Cardiovascular Disease (Cardiology) |
4385898154 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125055157 | IL | MD | Internal Medicine Physician |
| 036.128536 | IL | MD | Cardiovascular Disease Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Methodist Medical Center of Illinois | Current |
Accepting new patients | |
| Proctor Health Systems | Internal Medicine | Current |
Accepting new patients |
| Carle Health Care Incorporated | Internal Medicine | Current |
Accepting new patients |
| Pekin Prohealth Inc | Internal Medicine | Current |
Accepting new patients |
| Methodist Medical Center of Illinois | Current |
Accepting new patients | |
| Proctor Health Systems | Current |
Accepting new patients |
Locations
1506 W Garfield Ave
Bartonville, IL 61607
Phone (309) 697-2416
600 S 13th St
Pekin, IL 61554
Phone (309) 347-1151
112 NE Crescent Ave
Peoria, IL 61606
Phone (309) 680-2402
5401 N Knoxville Ave
Ste 400
Peoria, IL 61614
Phone (309) 691-6610
221 NE Glen Oak Ave
Ste 514W
Peoria, IL 61636
Phone (309) 672-5733
815 Main St
Ste A1
Peoria, IL 61602
221 NE Glen Oak Ave
Peoria, IL 61636
Phone (309) 672-4281
5401 N Knoxville Ave
Ste 204
Peoria, IL 61614
Phone (309) 683-1200
815 Main St
Ste A
Peoria, IL 61602
Phone (309) 672-4986
611 W Park St
Urbana, IL 61801
Phone (217) 383-6941
Interoperability endpoints
- mahmadmd388526@carlehiedirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cardiovascular Disease Physician | 207RC0000X | 036.128536 | IL | Yes |
| Internal Medicine Physician | 207R00000X | 125055157 | IL |
Addresses
Primary practice location
112 NE Crescent Ave
Peoria, IL 61606-1901
Mailing address
112 NE Crescent Ave
Peoria, IL 61606-1901
Phone (309) 672-4670
Other providers in Peoria, IL
- Devashish Agarwal
- Juanita Rodriguez Aguila-Corrales
- Christopher Chibuike Agusi
- Justin Ahlman
- Benjamin Henry Ahlrichs
- Aamina Ahmed
- Ammar Ahmed
- Faisal Vakil Ahmed
- Faiyaz Ahmed
- Mohsina Ahmed
All providers in Peoria, IL · Cardiovascular Disease Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.