Azra Mansoor, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

202855 Issued in NY

Practice address

260 East 188TH Street
Fordham Trement Ctr Mental Hea
Bronx, NY 10458

Phone

(718) 960-0420

Fax

(718) 933-8208

NPI assigned

Aug 29, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

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 1

Specialty

PsychiatryAlso: Addiction Medicine

Education

Other, 1962

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Center of Revitalizing Psychiatry, P.C.Group PAC ID 0648239988, 39 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Center of Revitalizing Psychiatry, P.C.

  • Psychiatry Physician
  • Rochelle Park, NJ
  • NPI 1356497960
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346359056",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 CENTER AVE",
            "address_2": "APT 1F",
            "city": "FORT LEE",
            "state": "NJ",
            "postal_code": "070244731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 EAST 188TH STREET",
            "address_2": "FORDHAM TREMENT CTR MENTAL HEA",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "10458",
            "telephone_number": "718-960-0420",
            "fax_number": "718-933-8208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOOR",
        "first_name": "AZRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "202855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00243361",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fatmata Mansaray, LPN
• Jose Antonio Mansen Arrieta, MD
• Mikaila Rian Mansfield, CNM/WHNP-BC
• Queen-Destiny Manson, CRPA
• Daniyal Mansoor Ali
• Madonna Ibrahim Mansour-Attaalla, DO
• Ali Mansour, MD
• Maryann B Mansour, M.D.
• Shirley Mansukhani, D.P.T.
• Abed Mansur, RPH

• Psychiatry Physician in Bronx, NY
• Providers in Bronx, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.