Mansoor Hussain Mirza, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

48060 Issued in WI

Practice address

2414 Kohler Memorial Drive
Sheboygan, WI 53081-3129

Phone

(920) 457-4461

Fax

(920) 459-1483

NPI assigned

Aug 29, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in WI, NJ2 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 2

Specialty

Internal Medicine

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Hackensack Meridian Health Medical Group - Specialty Care PCGroup PAC ID 9133032519, 1,901 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• West Allis Memorial Hospital Hospital, West Allis, WI, CCN 520139
• Jersey Shore University Medical Center Hospital, Neptune, NJ, CCN 310073
• Hackensack University Medical Center Hospital, Hackensack, NJ, CCN 310001
• Aurora Memorial Hospital Burlington Hospital, Burlington, WI, CCN 520059
• JFK University Medical Center Hospital, Edison, NJ, CCN 310108

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mmirza22504@direct.myadvocateaurora.org
• FHIR API: https://fhir4.healow.com/fhir/r4/IHJHBD

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.

• Aurora Medical Group, Inc.

  • Certified Registered Nurse Anesthetist
  • Milwaukee, WI
  • NPI 1427271378

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Hackensack Meridian Health Medical Group - Specialty Care PC

  • Surgical Critical Care Physician
  • Red Bank, NJ
  • NPI 1215989249

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Impact Physician Group, Wisconsin LLC

  • Internal Medicine Physician
  • Milwaukee, WI
  • NPI 1174291025
  Medicare reassignment NPD
• St Lukes Clinic-Treasure Valley LLC

  • Family Medicine Physician
  • Boise, ID
  • NPI 1326336058

  WI

  Medicare reassignment NPD
• Aurora Medical Group, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Oshkosh, WI
  • NPI 1326858044
  NPD
• Hackensack Meridian Health Medical Group - Specialty Care PC

  • Durable Medical Equipment & Medical Supplies
  • North Bergen, NJ
  • NPI 1215734199
  NPD
• Holy Family Memorial Inc

  • General Acute Care Hospital
  • Manitowoc, WI
  • NPI 1700998697
  NPD (past)

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

• Aurora Health Care Southern Lakes, Inc.

  • General Acute Care Hospital
  • Burlington, WI
  • NPI 1861557753
  Care Compare affiliation
• West Allis Memorial Hospital, Inc.

  • Clinic/Center
  • West Allis, WI
  • NPI 1235345695

  Hospital

  Care Compare affiliation
• West Allis Memorial Hospital, Inc.

  • General Acute Care Hospital
  • West Allis, WI
  • NPI 1407801640
  Care Compare affiliation
• HMH Hospitals Corporation

  • Clinic/Center
  • Neptune, NJ
  • NPI 1053880286

  Hospital

  Care Compare affiliation
• HMH Hospitals Corporation

  • General Acute Care Hospital
  • Edison, NJ
  • NPI 1144894577
  Care Compare affiliation
• HMH Hospitals Corporation

  • General Acute Care Hospital
  • Hackensack, NJ
  • NPI 1457456279
  Care Compare affiliation
• HMH Hospitals Corporation

  • Clinical Medical Laboratory
  • Hackensack, NJ
  • NPI 1518683929

  Hospital

  Care Compare affiliation
• HMH Hospitals Corporation

  • Clinical Medical Laboratory
  • Edison, NJ
  • NPI 1780301366

  Hospital

  Care Compare affiliation
• HMH Hospitals Corporation

  • General Acute Care Hospital
  • Neptune, NJ
  • NPI 1790297547
  Care Compare affiliation
• HMH Hospitals Corporation

  • Clinical Medical Laboratory
  • Neptune City, NJ
  • NPI 1962128496

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1508974502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 ROUTE 66 FL 3",
            "city": "NEPTUNE",
            "state": "NJ",
            "postal_code": "077532645",
            "telephone_number": "732-807-0877",
            "fax_number": "201-751-1680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2414 KOHLER MEMORIAL DRIVE",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813129",
            "telephone_number": "920-457-4461",
            "fax_number": "920-459-1483"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "30 Prospect Ave",
            "address_purpose": "LOCATION",
            "city": "Hackensack",
            "state": "NJ",
            "postal_code": "076011915",
            "country_code": "US",
            "telephone_number": "732-783-4746",
            "fax_number": "848-245-8571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIRZA",
        "first_name": "MANSOOR",
        "middle_name": "HUSSAIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "48060",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WI",
            "license": "48060",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK HEALTH PLAN",
            "identifier": "P00138179",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00252461",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "132679",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "390806395002",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34652100",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmirza22504@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "2414 Kohler Memorial Drive",
            "city": "Sheboygan",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530813129",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "2414 Kohler Memorial Drive",
            "city": "Sheboygan",
            "state": "WI",
            "country_code": "US",
            "postal_code": "530813129",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Stacy Miller, NP-C
• Jennifer Lynn Mills, D.C.
• Kiernan J Minehan, M.D.
• Lauren June Minten, OTR
• Sarah Mirocha, M.D.
• Chloe Mishler-Trerice
• Cooper Mocarski
• Moments Hospice of Sheboygan LLC
• Victoria Moore, MS, CCC-SLP
• Kimberly Moorer

• Internal Medicine Physician in Sheboygan, WI
• Providers in Sheboygan, WI by specialty
• Internal Medicine Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; 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.
• 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.