Active NPI
Faizmohamed M Mansuri, MD
- Internal Medicine Physician
- Moosic, PA
National Provider Identifier
1194756593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD427029
- Practice address
- 340 Montage Mountain Rd
Moosic, PA 18507-1782 - Phone
- (570) 589-0707
- Fax
- (570) 955-1971
- NPI assigned
- Jul 5, 2006
- Sex
- Male
- Sole proprietor
- No
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 | MD427029 | PA | Primary |
Addresses
Primary practice location
340 Montage Mountain Rd
Moosic, PA 18507-1782
Mailing address
2 Somerset Close
Moosic, PA 18507-2110
Phone (570) 589-0707
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| MA1736698 | Other | PA | BCBS |
| 101437233001 | Medicaid | PA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1020 W Lackawanna Ave
Scranton, PA 18504-2052
Phone (413) 584-2173
Hospital & facility affiliations
- Geisinger-Community Medical Center
- Geisinger Wyoming Valley Medical Center
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD427029 | PA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cleanslate Medical Group of Pennsylvania LLC | Current | Accepting new patients | |
| Bloomsburg Emergency Physicians, LLC | Past | Accepting new patients |
Locations
940 N New St
Ste 140
Bethlehem, PA 18018
Phone (484) 893-1482
1020 W Lackawanna Ave
Scranton, PA 18504
Phone (570) 290-4044
397 N 9th Ave
Scranton, PA 18504
Phone (570) 344-8619
100 N Wilkes Barre Blvd
Ste 103
Wilkes Barre, PA 18702
Phone (570) 846-2720
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- Wilkes Barre, PA
- NPI 1184177263
-
- Emergency Medicine Physician
- Bloomsburg, PA
- NPI 1336168483
Hospital & facility affiliations 30
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Endocrinology, Diabetes & Metabolism Physician
- Scranton, PA
- NPI 1306439856
Hospital
-
- General Acute Care Hospital
- Scranton, PA
- NPI 1366444507
-
- General Acute Care Hospital
- Scranton, PA
- NPI 1972652063
-
- Diagnostic Radiology Physician
- Scranton, PA
- NPI 1467850149
Hospital
-
- Radiology Clinic/Center
- Scranton, PA
- NPI 1548648272
Hospital
-
- Radiology Clinic/Center
- Scranton, PA
- NPI 1124405592
Hospital
-
- Physical Therapy Clinic/Center
- Scranton, PA
- NPI 1336526276
Hospital
-
- Sleep Disorder Diagnostic Clinic/Center
- Scranton, PA
- NPI 1417334350
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468281600000",
"number": "1194756593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 SOMERSET CLOSE",
"city": "MOOSIC",
"state": "PA",
"postal_code": "185072110",
"telephone_number": "570-589-0707",
"fax_number": "570-955-1971"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "340 MONTAGE MOUNTAIN RD",
"city": "MOOSIC",
"state": "PA",
"postal_code": "185071782",
"telephone_number": "570-589-0707",
"fax_number": "570-955-1971"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANSURI",
"first_name": "FAIZMOHAMED",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-05",
"last_updated": "2016-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "PA",
"license": "MD427029",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "MA1736698",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "101437233001",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Moosic, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.