Katrina Daisy Mansour

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

4444 W Bristol Rd Ste 150
Flint, MI 48507-3161

Phone

(833) 322-3376

Fax

(248) 607-6777

NPI assigned

Dec 10, 2025

Last updated

Apr 5, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dermatology and Cosmetic Center PLLCGroup PAC ID 0244600807, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Dermatology & Cosmetic Center PLLC

  • Dermatology Physician
  • Flint, MI
  • NPI 1811605660
  Medicare reassignment Care Compare group
• Dermatology & Cosmetic Center of Bloomfield Hills PLLC

  • Dermatology Physician
  • Bloomfield Hills, MI
  • NPI 1073479945
  Medicare reassignment NPD

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

{
    "created_epoch": "1765324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775347200000",
    "number": "1396609715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4444 W BRISTOL RD STE 150",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485073161",
            "telephone_number": "833-322-3376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4444 W BRISTOL RD STE 150",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485073161",
            "telephone_number": "833-322-3376",
            "fax_number": "248-607-6777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOUR",
        "first_name": "KATRINA",
        "middle_name": "DAISY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-12-10",
        "last_updated": "2026-04-05",
        "certification_date": "2026-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arvindpaul Singh Mangat, M.D.
• Keerthana Manjunath, MD
• Sreenivas Mannam, M.D.
• Cynthia Pearl Mannino, MSW
• Fay Mannion
• Mackenzie Mansour, PA
• Mohamed Mansour, MD
• Sandra Mens Manssur, NP
• Angeli V Mantos
• Jaquatta Deon Manuel

• Physician Assistant in Flint, MI
• Providers in Flint, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2026; 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.