Fatemeh Mansoori, C.F.N.P
Individual provider Active NPI Family Medicine Physician · Bosque Farms, NM
NPI 1346335759 · NPPES record last updated Apr 14, 2020
Key facts
- NPI
- 1346335759
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- CS00210250 (NM)
- Practice address
- 2230 Bosque Farms Blvd
Bosque Farms, NM 87068-9334 - Phone
- (505) 869-0300
- NPI assigned
- Oct 3, 2006
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- University of New Mexico School of Medicine, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2230 Bosque Farms Blvd
Bosque Farms, NM 87068-9334
Phone (505) 869-0300
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NM
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050207000047 | NM | Practitioner - Nurse Practitioner | 5890746952 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CS00210250 | NM | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southwest Medical Clinic Inc | Current |
Accepting new patients | |
| New Mexico Quickcare LLC | Family Medicine | Past | Accepting new patients |
Locations
2230 Bosque Farms Blvd
Bosque Farms, NM 87068
Phone (505) 869-0300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | CS00210250 | NM | Yes |
Addresses
Primary practice location
2230 Bosque Farms Blvd
Bosque Farms, NM 87068-9334
Mailing address
2230 Bosque Farms Blvd
Bosque Farms, NM 87068-9334
Phone (505) 869-0300
Other providers in Bosque Farms, NM
- Elizabeth Nickless Joyce
- Jacqueline Kelly-Romero
- Living Cross Ambulance Service, Inc.
- Living Waters Physical Therapy
- Amy Jeannie Maldonado
- Margie J Wesley, LLC
- Manuela Helena Moya
- Michelle Mari Nelson
- Nmbfd LTD
- Kreig Robert Peterson
All providers in Bosque Farms, NM · Family Medicine Physician in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 14, 2020. 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.