Individual provider Active NPI

Rami Taqeddin Mansour, M.D.

  • Family Medicine Physician
  • West Palm Beach, FL
National Provider Identifier
1386137487
Registry record updated Oct 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME152615 Issued in FL
Practice address
2007 Palm Beach Lakes Blvd
West Palm Beach, FL 33409-6501
Phone
(561) 688-5808
NPI assigned
Jun 13, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X ME152615 FL Primary

Addresses

Primary practice location

2007 Palm Beach Lakes Blvd
West Palm Beach, FL 33409-6501

Mailing address

2007 Palm Beach Lakes Blvd
West Palm Beach, FL 33409-6501
Phone (561) 688-5808

Other practice location 1

624 McClellan St Ste 101
Schenectady, NY 12304-1020
Phone (518) 347-5043

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20211006003194 FL Practitioner - Family Practice 5597163477 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MD Now Medical Centers IncGroup PAC ID 3971554825, 314 clinicians

Practice addresses (Care Compare)

2007 Palm Beach Lakes Blvd
West Palm Beach, FL 33409-6501
Phone (561) 420-8555

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME152615FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
MD Now Medical Centers Inc CurrentSince Sep 6, 2021 Accepting new patients
MD Now Medical Centers Inc CurrentSince Sep 6, 2021 Accepting new patients

Locations

1838 Rye Rd
#107
Bradenton, FL 34212
Phone (941) 462-2004

4570 Lantana Rd
Lake Worth, FL 33463
Phone (305) 949-4141

1770 NE Miami Gardens Dr
North Miami Beach, FL 33179
Phone (305) 949-4141

2007 Palm Beach Lakes Blvd
West Palm Beach, FL 33409

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666396800000",
    "number": "1386137487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2007 PALM BEACH LAKES BLVD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334096501",
            "telephone_number": "561-688-5808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2007 PALM BEACH LAKES BLVD",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "334096501",
            "telephone_number": "561-688-5808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "624 McClellan St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Schenectady",
            "state": "NY",
            "postal_code": "123041020",
            "country_code": "US",
            "telephone_number": "518-347-5043",
            "fax_number": "518-347-5196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANSOUR",
        "first_name": "RAMI",
        "middle_name": "TAQEDDIN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-13",
        "last_updated": "2022-10-22",
        "certification_date": "2022-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME152615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.