Active NPI
Ameen Manasrah
- Nurse Practitioner
- Fresno, CA
National Provider Identifier
1497904882
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 14923
- Practice address
- 4910 E Clinton Way
101
Fresno, CA 93727-1560 - Phone
- (559) 443-2682
- Fax
- (559) 443-2681
- NPI assigned
- Sep 10, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 14923 | CA | Primary |
Addresses
Primary practice location
4910 E Clinton Way
101
Fresno, CA 93727-1560
Mailing address
PO Box 26118
Fresno, CA 93729-6118
Phone (559) 283-7718
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130425000190 | CA | Order and Referring Only - Nurse Practitioner | 7012071624 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Interoperability endpoints
- amanasrah574485@direct.llu.edu
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1221004800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221004800000",
"number": "1497904882",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 26118",
"city": "FRESNO",
"state": "CA",
"postal_code": "937296118",
"telephone_number": "559-283-7718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4910 E CLINTON WAY",
"address_2": "101",
"city": "FRESNO",
"state": "CA",
"postal_code": "937271560",
"telephone_number": "559-443-2682",
"fax_number": "559-443-2681"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANASRAH",
"first_name": "AMEEN",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-09-10",
"last_updated": "2008-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "CA",
"license": "14923",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fresno, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2008; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.