Individual provider Active NPI

Rabeea Mansoor, M.D

  • Child & Adolescent Psychiatry Physician
  • Corpus Christi, TX
National Provider Identifier
1366882441
Registry record updated Oct 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
R0070 Issued in TX
Practice address
3643 S Staples St Ste B
Corpus Christi, TX 78411
Phone
(361) 694-1550
Fax
(361) 808-2766
NPI assigned
Jul 3, 2013
Last updated
Oct 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Child & Adolescent Psychiatry Physician 2084P0804X R0070 TX Primary

Addresses

Primary practice location

3643 S Staples St Ste B
Corpus Christi, TX 78411

Mailing address

3643 S Staples St Ste B
Corpus Christi, TX 78411-2456
Phone (361) 694-1550

Other identifiers 1

IdentifierTypeStateIssuer
381489901MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20180306000071 TX Practitioner - Psychiatry 3476796319 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R0070TXMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Metrohealth System Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: rmansoor54920@direct.metrohealth.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1372809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602720000000",
    "number": "1366882441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3643 S STAPLES ST STE B",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784112456",
            "telephone_number": "361-694-1550",
            "fax_number": "361-808-2766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3643 S STAPLES ST STE B",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "78411",
            "telephone_number": "361-694-1550",
            "fax_number": "361-808-2766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOOR",
        "first_name": "RABEEA",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-03",
        "last_updated": "2020-10-15",
        "certification_date": "2020-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "TX",
            "license": "R0070",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "381489901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Corpus Christi, TX

Sources for this page

Verify at the official NPI Registry.