Individual provider Active NPI

Michael Mansour, M.D.

  • Interventional Cardiology Physician
  • Birmingham, AL
National Provider Identifier
1326077058
Registry record updated Aug 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Cardiology PhysicianTaxonomy code 207RI0011X
License
44178 Issued in AL
Practice address
619 19TH St S
Birmingham, AL 35233-1900
Phone
(205) 934-4011
NPI assigned
Jul 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 10715 MS
Cardiovascular Disease Physician 207RC0000X 44178 AL
Interventional Cardiology Physician 207RI0011X 44178 AL Primary

Addresses

Primary practice location

619 19TH St S
Birmingham, AL 35233-1900

Mailing address

PO Box 55310
Birmingham, AL 35255-5310

Other practice location 1

1700 Spring Hill Ave Ste 100
Mobile, AL 36604-1416
Phone (251) 435-1200

Other identifiers 3

IdentifierTypeStateIssuer
134987001OtherMEDICAID OF ARKANSAS
00118990MedicaidMS
060048938OtherMSMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, AL2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20101123000056 MS Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 6103841754 Reassigns benefits to 1 organization
I20220523000479 AL Practitioner - Interventional CardiologyPractitioner - Cardiovascular Disease (Cardiology) 6103841754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Cardiology
Education
University of Mississippi School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Imc-Diagnostic and Medical Clinic LLCGroup PAC ID 2860399623, 168 clinicians

Practice addresses (Care Compare)

1700 Springhill Ave
Suite 100
Mobile, AL 36604-1416
Phone (251) 435-1200

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting18
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44178ALMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Delta Medical Group CurrentSince Sep 13, 2018 Accepting new patients
Imc-Diagnostic and Medical Clinic LLC CurrentSince Jul 1, 2022 Accepting new patients
Imc-Diagnostic and Medical Clinic LLC Cardiovascular Disease CurrentSince Jul 1, 2022 Accepting new patients
Delta Physician Practices Past Accepting new patients

Locations

1700 Spring Hill Ave
Ste 100
Mobile, AL 36604

1725 Spring Hill Ave
Mobile, AL 36604
Phone (251) 435-1366

1693 Fairgrounds Rd
Greenville, MS 38703
Phone (662) 378-3783

Interoperability endpoints

  • Direct secure messaging: mmansour113982@directinfirmaryhealth.org

Organizations & group practices 4

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1786579200000",
    "number": "1326077058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 55310",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352555310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 19TH ST S",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352331900",
            "telephone_number": "205-934-4011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 Spring Hill Ave Ste 100",
            "address_purpose": "LOCATION",
            "city": "Mobile",
            "state": "AL",
            "postal_code": "366041416",
            "country_code": "US",
            "telephone_number": "251-435-1200",
            "fax_number": "251-435-6357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANSOUR",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2026-08-13",
        "certification_date": "2026-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MS",
            "license": "10715",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AL",
            "license": "44178",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "AL",
            "license": "44178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID OF ARKANSAS",
            "identifier": "134987001",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00118990",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "060048938",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

Verify at the official NPI Registry.