Individual provider Active NPI

Ali Mansour, MD

  • Internal Medicine Physician
  • Bronx, NY
National Provider Identifier
1427279017
Registry record updated Feb 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
294266 Issued in NY
Practice address
3400 Bainbridge Ave FL 5
Bronx, NY 10467-2404
Phone
(718) 920-5864
Fax
(718) 324-5062
NPI assigned
May 1, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 35113 SC
Pulmonary Disease Physician 207RP1001X 35113 SC
Sleep Medicine (Internal Medicine) Physician 207RS0012X 35113 SC
Internal Medicine Physician 207R00000X 294266 NY Primary

Addresses

Primary practice location

3400 Bainbridge Ave FL 5
Bronx, NY 10467-2404

Mailing address

3400 Bainbridge Ave FL 5
Bronx, NY 10467-2404
Phone (718) 920-5864

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, TX, NY3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20120827000255 SC Practitioner - Critical Care (Intensivists)Practitioner - Internal MedicinePractitioner - Pulmonary Disease 6800043878 Reassigns benefits to 1 organization
I20200117000048 TX Practitioner - Internal MedicinePractitioner - Hospitalist 6800043878 Reassigns benefits to 1 organization
I20210210002392 NY Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 6800043878 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 2004
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Montefiore Medical CenterGroup PAC ID 3779496021, 2,809 clinicians

Practice addresses (Care Compare)

111 E 210TH St
Bronx, NY 10467-2401
Phone (718) 920-4321

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35113SCMDSleep Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Regional Medical Center of the Pee Dee, Inc CurrentSince Apr 3, 2017 Accepting new patients
Montefiore Medical Center CurrentSince Nov 10, 2020 Accepting new patients
McLeod Regional Medical Center of the Pee Dee, Inc Internal Medicine CurrentSince Apr 3, 2017 Accepting new patients
Austin Critical Care Specialists PA Critical Care Medicine Current Accepting new patients
Montefiore Medical Center Internal Medicine CurrentSince Nov 10, 2020 Accepting new patients
Austin Critical Care Specialists PA Critical Care Medicine CurrentSince Dec 1, 2019 Accepting new patients
Montefiore Medical Center Past Accepting new patients

Locations

111 E 210th St
Bronx, NY 10467

555 E Cheves St
Florence, SC 29506
Phone (843) 662-5233

11113 Research Blvd
Austin, TX 78759
Phone (512) 324-1125

850 W Central Texas Expy
Killeen, TX 76548
Phone (254) 690-0900

6001 Kyle Pkwy
Kyle, TX 78640
Phone (512) 504-5000

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: amansour@montefioredirect.com

Organizations & group practices 7

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708646400000",
    "number": "1427279017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 BAINBRIDGE AVE FL 5",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672404",
            "telephone_number": "718-920-5864",
            "fax_number": "718-324-5062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 BAINBRIDGE AVE FL 5",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104672404",
            "telephone_number": "718-920-5864",
            "fax_number": "718-324-5062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOUR",
        "first_name": "ALI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-01",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "SC",
            "license": "35113",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "SC",
            "license": "35113",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "SC",
            "license": "35113",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "294266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

Verify at the official NPI Registry.