Individual provider Active NPI

Irfan Mansuri, MD

  • Family Medicine Physician
  • Pasadena, TX
National Provider Identifier
1487740767
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
L6105 Issued in TX
Practice address
5001 E Sam Houston Pkwy S
Pasadena, TX 77505-3965
Phone
(713) 442-7100
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X L6105 TX Primary

Addresses

Primary practice location

5001 E Sam Houston Pkwy S
Pasadena, TX 77505-3965

Mailing address

11511 Shadow Creek Pkwy
Pearland, TX 77584-7298
Phone (713) 442-0000

Other identifiers 3

IdentifierTypeStateIssuer
060017302MedicaidTX
060017305MedicaidTX
060017304MedicaidTX

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address imansuri1656@direct.kelsey-seybold.com Direct
FHIR URL https://ssrx.ksnet.com/FhirProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20101201000805 TX Practitioner - Family Practice 7810183993 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kelsey-Seybold Medical Group, PLLCGroup PAC ID 9739093527, 941 clinicians

Practice addresses (Care Compare)

15655 Cypress Wood Medical Dr
Suite 100
Houston, TX 77014-1487
Phone (713) 442-1700

2727 W Holcombe Blvd
Houston, TX 77025-1669
Phone (713) 442-0000

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Kelsey-Seybold Medical Group, PLLC Family Medicine CurrentSince Feb 24, 2003 Accepting new patients
Village Chiropractic and Wellness P.L.L.C. Past Accepting new patients

Locations

1560 W Bay Area Blvd
Ste 100
Friendswood, TX 77546
Phone (713) 442-4400

6624 Fannin St
Houston, TX 77030
Phone (713) 442-1500

2727 W Holcombe Blvd
Houston, TX 77025
Phone (713) 790-9412

23000 Highland Knolls Blvd
Katy, TX 77494
Phone (713) 442-4200

3023 Marina Bay Dr
Ste 104
League City, TX 77573
Phone (281) 334-7737

7010 Highway 6
Missouri City, TX 77459
Phone (713) 442-4200

5001 E Sam Houston Pkwy S
Pasadena, TX 77505
Phone (713) 442-7100

11511 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 442-4997

2515 Business Center Dr
Pearland, TX 77584
Phone (713) 442-7200

Interoperability endpoints

  • Direct secure messaging: imansuri1656@direct.kelsey-seybold.com

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": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1487740767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11511 SHADOW CREEK PKWY",
            "city": "PEARLAND",
            "state": "TX",
            "postal_code": "775847298",
            "telephone_number": "713-442-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 E SAM HOUSTON PKWY S",
            "city": "PASADENA",
            "state": "TX",
            "postal_code": "775053965",
            "telephone_number": "713-442-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSURI",
        "first_name": "IRFAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L6105",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060017302",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060017305",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "060017304",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "imansuri1656@direct.kelsey-seybold.com",
            "affiliation": "N",
            "endpointDescription": "digital contact information",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5001 E Sam Houston Pkwy S",
            "city": "Pasadena",
            "state": "TX",
            "country_code": "US",
            "postal_code": "775053965",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://ssrx.ksnet.com/FhirProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FHIR endpoint URL",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5001 E Sam Houston Pkwy S",
            "city": "Pasadena",
            "state": "TX",
            "country_code": "US",
            "postal_code": "775053965",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pasadena, TX

Sources for this page

Verify at the official NPI Registry.