NPIMap

Individual provider Active NPI

George Mansour, MD

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1194072835
Registry record updated Apr 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
2015021633 Issued in MO
Practice address
11040 Sandistan Dr
Saint Louis, MO 63146-5583
Phone
(402) 208-2254
NPI assigned
Aug 13, 2012
Sex
Male
Sole proprietor
No

Organizations & group practices 10

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 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospitalist
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aging Well Health Care, LLC 236 clinicians

Practice addresses (Care Compare)

7212 Balson Ave
Saint Louis, MO 63130-3001

Hospital & facility affiliations

  • Aw Health Care Home health agency, Saint Louis, MO, CCN 267585
  • Alpine Care Home Health Home health agency, Saint Louis, MO, CCN 267643
  • Healthy Family Home Care, LLC Home health agency, Ellisville, MO, CCN 267665
  • Alpine Home Health Agency, Inc Home health agency, Ballwin, MO, CCN 267642
  • Elara Caring Home health agency, Bridgeton, MO, CCN 267595
  • Suncrest Hospice of St Louis, LLC Hospice, Saint Louis, MO, CCN 261717
  • Breeze Hospice of Missouri Hospice, Ballwin, MO, CCN 261671
  • BJC Hospice Hospice, Saint Louis, MO, CCN 261511
  • Unity Hospice GSL, LLC Hospice, Saint Louis, MO, CCN 261640
  • Barnes-Jewish St Peters Hospital Hospital, Saint Peters, MO, CCN 260191
  • Christian Hospital Northeast Hospital, Saint Louis, MO, CCN 260180
  • Missouri Baptist Medical Center Hospital, Saint Louis, MO, CCN 260108
  • SSM St Joseph Health Center Hospital, Saint Charles, MO, CCN 260005
  • Lakeview Post Acute Nursing home, Florissant, MO, CCN 265838
  • St Peters Post Acute Nursing home, Saint Peters, MO, CCN 265824

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150714002939 MO Practitioner - Internal MedicinePractitioner - Hospitalist 6406169846 Reassigns benefits to 3 organizations

All facility ownership & control disclosures 1

Medicare enrollment files

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Suncrest Hospice St Louis, LLCDes Peres, MO, CCN 261717 Hospice Contracted Managing Employee May 1, 2025

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
GM Health LLC Internal Medicine CurrentSince Mar 20, 2023 Accepting new patients
Galen Inpatient Physicians PC Hospitalist CurrentSince Nov 26, 2019 Accepting new patients
Galen Inpatient Physicians PC. Internal Medicine CurrentSince Nov 26, 2019 Accepting new patients
Beauvais Operator LLC Past Accepting new patients
Suncrest Hospice St Louis, LLC PastSince May 1, 2025 Accepting new patients
Christian Hospital Northeast- Northwest Past Accepting new patients
Barnes Jewish St Peters Hospital Inc Past Accepting new patients
Florissant Skilled Nursing, LLC Past Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

Interoperability endpoints

  • Direct secure messaging: gmansour203481@direct-ehr-ssmhc.com
  • FHIR API: https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 2015021633 MO Primary

Addresses

NPPES NPI Registry

Primary practice location

11040 Sandistan Dr
Saint Louis, MO 63146-5583

Mailing address

11040 Sandistan Dr
Saint Louis, MO 63146-5583
Phone (402) 208-2254

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
ENROLLEDMedicaidIL

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 18, 2023.

{
    "created_epoch": "1344816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681776000000",
    "number": "1194072835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11040 SANDISTAN DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631465583",
            "telephone_number": "402-208-2254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11040 SANDISTAN DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631465583",
            "telephone_number": "402-208-2254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOUR",
        "first_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-13",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MO",
            "license": "2015021633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ENROLLED",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

Verify at the official NPI Registry.