Individual provider Active NPI

Jena Mansour

  • Certified Registered Nurse Anesthetist
  • Irving, TX
National Provider Identifier
1497382758
Registry record updated Feb 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
141867 Issued in CT
Practice address
6225 N State Highway 161 Ste 200
Irving, TX 75038-2241
Phone
(214) 687-0001
Fax
(972) 518-2100
NPI assigned
Mar 26, 2020
Last updated
Feb 24, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 141867 CT Primary

Addresses

Primary practice location

6225 N State Highway 161 Ste 200
Irving, TX 75038-2241

Mailing address

6225 N State Highway 161 Ste 200
Irving, TX 75038-2241
Phone (214) 687-0001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200605001947 KY Practitioner - Certified Registered Nurse Anesthetist (Crna) 4789005323 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Anesthesia Services of Kentucky PLLCGroup PAC ID 0244590305, 351 clinicians
S4 Anesthesia Services PLLCGroup PAC ID 8628442191, 5 clinicians

Practice addresses (Care Compare)

1801 Ashley Cir
Bowling Green, KY 42104-3362
Phone (270) 793-1000

200 E Chestnut St
Louisville, KY 40202-1831
Phone (502) 629-8000

440 Hopkinsville St
Greenville, KY 42345-1124
Phone (270) 338-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
141867CTMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Health Corporation, Inc CurrentSince Mar 16, 2024 Accepting new patients
Commonwealth Health Corporation, Inc. CurrentSince Mar 16, 2024 Accepting new patients
Northstar Anesthesia of Kentucky, PLLC Nurse Anesthetist, Certified Registered CurrentSince May 2, 2020 Accepting new patients
Commonwealth Health Corporation, Inc Current Accepting new patients
S4 Anesthesia Services PLLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2025 Accepting new patients
Forefront Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2023 Accepting new patients
Professional Anesthesia Services of Kentucky PLLC Nurse Anesthetist, Certified Registered CurrentSince Nov 11, 2023 Accepting new patients
Vanderbilt University Medical Center PastSince Aug 16, 2023 Accepting new patients

Locations

250 Park St
Bowling Green, KY 42101
Phone (270) 745-1000

350 Park St
Ste 203
Bowling Green, KY 42101
Phone (270) 781-0075

913 N Dixie Ave
Elizabethtown, KY 42701
Phone (270) 706-1212

440 Hopkinsville St
Greenville, KY 42345
Phone (270) 338-8000

200 E Chestnut St
Louisville, KY 40202
Phone (502) 446-8000

1099 Medical Center Cir
Mayfield, KY 42066
Phone (270) 251-4100

1000 Breckenridge St
Ste 100
Owensboro, KY 42303
Phone (270) 683-2751

1201 Pleasant Valley Rd
Owensboro, KY 42303
Phone (270) 417-2000

1625 Nashville St
Russellville, KY 42276
Phone (270) 726-4011

6225 State Highway 161
Ste 200
Irving, TX 75038
Phone (214) 687-0496

Organizations & group practices 8

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.

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": "1585180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645660800000",
    "number": "1497382758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6225 N STATE HIGHWAY 161 STE 200",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382241",
            "telephone_number": "214-687-0001",
            "fax_number": "972-518-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6225 N STATE HIGHWAY 161 STE 200",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750382241",
            "telephone_number": "214-687-0001",
            "fax_number": "972-518-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOUR",
        "first_name": "JENA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-26",
        "last_updated": "2022-02-24",
        "certification_date": "2022-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "CT",
            "license": "141867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irving, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.