Mansour Nejadrasool, DPM

Individual provider Active NPI Foot Surgery Podiatrist · Van Nuys, CA

NPI 1477565828 · NPPES record last updated Aug 29, 2018

Key facts

NPI
1477565828
Entity type
Individual (NPI type 1)
Primary specialty
Foot Surgery Podiatrist 213ES0131X
License
E4452 (CA)
Practice address
14600 Sherman Way Ste 230
Van Nuys, CA 91405
Phone
(818) 784-8420
Fax
(818) 785-0028
NPI assigned
Aug 13, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 5

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.

Medicare Care Compare profile

Specialty
Podiatry
Education
Temple University School of Podiatric Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14600 Sherman Way
Suite 230
Van Nuys, CA 91405-2291
Phone (818) 784-8420

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue25
Removal of nail tissue135
Removal or shaving of skin growth54

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20040514001274 CA Practitioner - Podiatry 3274522339 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles (4 of 5)

OrganizationSpecialtyStatusNew patients
Mercy Health - Fairfield Hospital LLC Past Accepting new patients
Christ Hospital Past Accepting new patients
Mahfouz M. Michael,M.D.,Inc. Past Accepting new patients
Valley Presbyterian Hospital Past Accepting new patients

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X E4452 CA
Foot Surgery Podiatrist 213ES0131X E4452 CA Yes

Addresses

Primary practice location

14600 Sherman Way Ste 230
Van Nuys, CA 91405

Mailing address

14600 Sherman Way Ste 230
Van Nuys, CA 91405-2291
Phone (818) 784-8420

Other identifiers

IdentifierTypeStateIssuer
6445430003OtherCANORIDIAN SECOND PTAN FOR VAN NUYS CLINIC

Other providers in Van Nuys, CA

All providers in Van Nuys, CA · Foot Surgery Podiatrist in California

Sources for this page

Verify at the official NPI Registry.