Mehrdad Ali Mansouri, M.D., PH.D.

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

A101584 Issued in CA

Practice address

2500 Alhambra Ave
Martinez, CA 94553-3156

Phone

(925) 370-5200

NPI assigned

Oct 18, 2005

Last updated

Feb 11, 2022By 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 1

Addresses

Electronic endpoints 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family PracticeAlso: Hospitalist

Education

Albany Medical College of Union University, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Permanente Medical Group IncGroup PAC ID 8921910225, 10,928 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kaiser Foundation Hospital - Oakland/Richmond Hospital, Oakland, CA, CCN 050075

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  Medicare reassignment Care Compare group NPD
• John Muir Physician Network

  • General Practice Physician
  • Walnut Creek, CA
  • NPI 1841407665
  Medicare reassignment NPD
• Providence Medical Foundation

  • Family Medicine Physician
  • Brea, CA
  • NPI 1871607762
  Medicare reassignment NPD (past)
• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Richmond, CA
  • NPI 1235226531
  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD
• Providence Medical Foundation

  • General Practice Physician
  • Diamond Bar, CA
  • NPI 1285890624
  NPD
• St. Joseph Health Northern California, LLC

  dba Providence Queen of the Valley Medical Center

  • Rehabilitation Hospital Unit
  • Napa, CA
  • NPI 1609947282
  NPD (past)
• Bitter Creek Inpatient Services LLC

  • Hospitalist Physician
  • Rock Springs, WY
  • NPI 1881963882
  NPD (past)

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

• Kaiser Foundation Hospitals

  dba Kaiser Foundation Hospital Oakland-Richmond

  • General Acute Care Hospital
  • Oakland, CA
  • NPI 1427123132
  Care Compare affiliation

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644537600000",
    "number": "1376532747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "528 CLYNE CT",
            "city": "BENICIA",
            "state": "CA",
            "postal_code": "945103842",
            "telephone_number": "707-365-7039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 ALHAMBRA AVE",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "945533156",
            "telephone_number": "925-370-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOURI",
        "first_name": "MEHRDAD",
        "middle_name": "ALI",
        "name_prefix": "Dr.",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2022-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "CA",
            "license": "A101584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1425 South Main Street",
            "city": "Walnut Creek",
            "state": "CA",
            "country_code": "US",
            "postal_code": "94596",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stanley Manalansan
• Khelmer Estanislao Manalo, PHYSICAL THERAPIST
• Victoria A. Mancuso, MD
• Kim M Mangante, RAS
• Cyrus Manian
• Wilfredo Manuntag
• Alexis Mapel
• Neeraja V. Maramreddy, MD
• Amber Dawn Marcellin, OTR
• Jade Emmanny Batungbacal Marcos, MD

• Hospitalist Physician in Martinez, CA
• Providers in Martinez, CA by specialty
• Hospitalist Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; 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.