Sam Edward Mansour, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

0101233782 Issued in VA

Practice address

45 N Hill Dr Ste 202
Warrenton, VA 20186-2677

Phone

(540) 349-1882

Fax

(703) 738-7157

NPI assigned

Apr 7, 2006

Last updated

Apr 11, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in DC, VA2 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

Ophthalmology

Education

Other, 1986

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Virginia Retina Center LLCGroup PAC ID 9335106814, 5 clinicians

Medical Faculty Associates, IncGroup PAC ID 4082528898, 676 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Fauquier Hospital Hospital, Warrenton, VA, CCN 490023

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: smansour19744@gwmfa.direct-ci.com

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.

• Virginia Retina Center LLC

  • Ophthalmology Physician
  • Warrenton, VA
  • NPI 1093869976
  Medicare reassignment Care Compare group NPD
• Medical Faculty Associates, Inc

  • Anesthesiology Physician
  • Washington, DC
  • NPI 1417990581

  Ophthalmology

  Medicare reassignment Care Compare group NPD
• Bert M. Glaser National Retina Institute, LLC

  dba The National Retina Institute

  • Ophthalmology Physician
  • Towson, MD
  • NPI 1962456780
  NPD (past)
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Katzen Medical Associates, PC

  dba National Retina Institute

  • Ophthalmology Physician
  • Lutherville, MD
  • NPI 1326052614
  NPD (past)

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

• Fauquier Medical Center LLC

  dba Fauquier Health

  • General Acute Care Hospital
  • Warrenton, VA
  • NPI 1912334517
  Care Compare affiliation

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1376506873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 N HILL DR STE 202",
            "city": "WARRENTON",
            "state": "VA",
            "postal_code": "201862677",
            "telephone_number": "540-349-1882",
            "fax_number": "703-738-7157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 N HILL DR STE 202",
            "city": "WARRENTON",
            "state": "VA",
            "postal_code": "201862677",
            "telephone_number": "540-349-1882",
            "fax_number": "703-738-7157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOUR",
        "first_name": "SAM",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A49545",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D0059626",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "DC",
            "license": "MD 34095",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "VA",
            "license": "0101233782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037331500",
            "state": "DC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010107067",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010107024",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "143213",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thuy Ngoc Ly
• Lynn H Samuel MD LLC
• Joanna Leigh Macias
• Louis Magdon III, MD
• Gajan A Mahendiran, M.D.
• John Laurence Manwaring, M.D.
• Demetrius S. Maoury, M.D.
• Douglas Eugene Martin, PT
• Elizabeth Stone Martin, MD
• Barbara Masiello, O.D.

• Ophthalmology Physician in Warrenton, VA
• Providers in Warrenton, VA by specialty
• Ophthalmology Physician in Virginia

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