Anissa Mansoori, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

A125067 Issued in CA

Practice address

27800 Medical Center Rd Ste 220
Mission Viejo, CA 92691-6408

Phone

(949) 545-6605

Fax

(949) 326-7509

NPI assigned

Jun 24, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

F Awadalla MD PCGroup PAC ID 0446685481, 5 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

97.59 of 100Reported as group

Quality

95.18

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• F Awadalla MD PC

  • Dermatology Physician
  • Mission Viejo, CA
  • NPI 1255982724
  Medicare reassignment Care Compare group
• Ocean Skin and Vein Institute

  • Dermatology Physician
  • Tustin, CA
  • NPI 1790246841
  Medicare reassignment
• F Awadalla MD PC

  • Foot & Ankle Surgery Podiatrist
  • Mission Viejo, CA
  • NPI 1740164326
  NPD (past)
• Atlanta Center of Dermatology and Medispa PC

  • Dermatology Physician
  • Atlanta, GA
  • NPI 1568533180
  NPD (past)
• Kayal Dermatology & Skin Cancer Specialists

  • Specialist
  • Marietta, GA
  • NPI 1235358441
  NPD (past)

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

{
    "created_epoch": "1498262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1356861975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27800 MEDICAL CENTER RD STE 220",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916408",
            "telephone_number": "949-545-6605",
            "fax_number": "949-326-7509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27800 MEDICAL CENTER RD STE 220",
            "city": "MISSION VIEJO",
            "state": "CA",
            "postal_code": "926916408",
            "telephone_number": "949-545-6605",
            "fax_number": "949-326-7509"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "31655 Coast Hwy Ste A",
            "address_purpose": "LOCATION",
            "city": "Laguna Beach",
            "state": "CA",
            "postal_code": "926517019",
            "country_code": "US",
            "telephone_number": "949-545-6605",
            "fax_number": "949-326-7509",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANSOORI",
        "first_name": "ANISSA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-24",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "A125067",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "8205",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan T. Manabo, FNP
• Katherine Manasson, M.D.
• Lara A Manchik, P.A.C.
• Christine Manger
• Mary Jeanette Mannino, CRNA
• Mantecon Family Counseling Inc
• Nicole E. Mantegna, PSY.D
• April Manter
• Michael S Marandola, MD
• Kent S Marangi, MD

• Physician Assistant in Mission Viejo, CA
• Providers in Mission Viejo, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2024; 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.