Mansour Mohamed Issam Mansour, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

5151014003 Issued in MI

Practice address

10000 Telegraph Rd
Taylor, MI 48180-3330

Phone

(313) 295-5000

NPI assigned

Jun 18, 2019

Last updated

Sep 11, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI, OH2 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

Specialty

Emergency Medicine

Education

Lake Erie College of Osteopathic Medicine, Erie, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mercy Emergency Care Services IncGroup PAC ID 9436475795, 64 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy St Vincent Medical Center Hospital, Toledo, OH, CCN 360112

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmansour1245029@epic00.shdirect.org
• Direct secure messaging: mmansour2679504@direct.beaumont.edu

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mercy Emergency Care Services, Inc.

  • Emergency Medicine Physician
  • Toledo, OH
  • NPI 1477957819
  Medicare reassignment Care Compare group NPD
• Beaumont Medical Group Hospital -Based Services

  • Hospitalist Physician
  • Royal Oak, MI
  • NPI 1427567858
  Medicare reassignment NPD
• Emergency Professionals of Michigan, P.C.

  • Emergency Medicine Physician
  • Dearborn, MI
  • NPI 1952740656
  Medicare reassignment NPD
• Emergency Professional Services, Inc.

  dba Emergency Professional Services of Ohio, Inc.

  • Emergency Medicine Physician
  • Seaman, OH
  • NPI 1093762353
  Medicare reassignment NPD
• Bronx Family Pharmacy Corp

  • Pharmacy
  • Bronx, NY
  • NPI 1154748937
  NPD (past)
• Cedar Park Express Pharmacy Inc.

  • Community/Retail Pharmacy
  • Cedar Park, TX
  • NPI 1477397628
  NPD (past)
• Pharmacare Plus Inc

  • Community/Retail Pharmacy
  • Astoria, NY
  • NPI 1295078459
  NPD (past)
• Steinway Pharmacy

  • Community/Retail Pharmacy
  • Astoria, NY
  • NPI 1841335494
  NPD (past)
• Valley Stream Pharmacy Inc

  dba Valley Stream Pharmacy

  • Community/Retail Pharmacy
  • Valley Stream, NY
  • NPI 1982078978
  NPD (past)

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

• Mercy Health - St Vincent Medical Center LLC

  dba Mercy Health St Vincent Medical Center

  • General Acute Care Hospital
  • Toledo, OH
  • NPI 1467493551
  Care Compare affiliation

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

{
    "created_epoch": "1560816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1366002735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4965 HEATHER DR APT 202",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481264175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10000 TELEGRAPH RD",
            "city": "TAYLOR",
            "state": "MI",
            "postal_code": "481803330",
            "telephone_number": "313-295-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4965 Heather Dr Apt 107",
            "address_purpose": "LOCATION",
            "city": "Dearborn",
            "state": "MI",
            "postal_code": "481262862",
            "country_code": "US",
            "telephone_number": "419-442-1707",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2600 Navarre Ave",
            "address_purpose": "LOCATION",
            "city": "Oregon",
            "state": "OH",
            "postal_code": "436163207",
            "country_code": "US",
            "telephone_number": "419-696-7411",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3404 W Sylvania Ave",
            "address_purpose": "LOCATION",
            "city": "Toledo",
            "state": "OH",
            "postal_code": "436234467",
            "country_code": "US",
            "telephone_number": "419-407-2663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANSOUR",
        "first_name": "MANSOUR MOHAMED",
        "middle_name": "ISSAM",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-06-18",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "34.016312",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5151014003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmansour2679504@direct.beaumont.edu",
            "affiliation": "N",
            "address_1": "10000 Telegraph Rd",
            "city": "Taylor",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481803330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Malinowski, Osborne & Associates
• Susan Marie Mandreger, LBSW
• Manoo Boonsiri,M.D.,P.C.
• Karmen Michael Manoogian, RN
• Hassan Mansour, MD
• Ifra Maqsood
• Marathon Health, LLC (Marathon Health @ Taylor)
• Floare Marcoe, OTR
• Felicia Marcela Marginean
• Jonathan Marginean

• Emergency Medicine Physician in Taylor, MI
• Providers in Taylor, MI by specialty
• Emergency Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.