NPIMap

Individual provider Active NPI

Mumtaz Thomas Almansour, M.D.

  • Family Medicine Physician
  • El Cajon, CA
National Provider Identifier
1558567446
Registry record updated Feb 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A55926 Issued in CA
Practice address
330 S Magnolia Ave
Suite 101
El Cajon, CA 92020-5290
Phone
(619) 584-1612
Fax
(619) 281-6738
NPI assigned
Jun 26, 2007
Last updated
Feb 16, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2017

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 A55926 CA Primary

Addresses

Primary practice location

330 S Magnolia Ave
Suite 101
El Cajon, CA 92020-5290

Mailing address

330 S Magnolia Ave
Suite 101
El Cajon, CA 92020-5290
Phone (619) 584-1612

Other identifiers 1

IdentifierTypeStateIssuer
00A559261MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040712001620 CA Practitioner - Family Practice 5698753952 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
La Maestra Family Clinic, Inc.Group PAC ID 7113968512, 13 clinicians
East County Family Health Center IncGroup PAC ID 8527024942, 2 clinicians

Practice addresses (Care Compare)

1032 Broadway
El Cajon, CA 92021-7416
Phone (619) 779-7900

181 Rea Ave
El Cajon, CA 92020-3985
Phone (619) 280-4213

330 S Magnolia Ave
Suite 101
El Cajon, CA 92020-5221
Phone (619) 593-3007

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
22.7 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
75.67

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
East County Health Center Inc Current Accepting new patients
La Maestra Family Clinic, Inc. Current Accepting new patients
La Maestra Family Clinic, Inc. CurrentSince Jul 1, 2016 Accepting new patients
La Maestra Family Clinic, Inc. CurrentSince Jul 1, 2016 Accepting new patients
Sharp Memorial Hospital Past Accepting new patients

Locations

1032 Broadway
El Cajon, CA 92021
Phone (619) 402-5653

165 S 1st St
El Cajon, CA 92019
Phone (619) 312-0347

330 S Magnolia Ave
Ste 101
El Cajon, CA 92020
Phone (619) 277-4678

4060 Fairmount Ave
San Diego, CA 92105
Phone (619) 255-9155

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: mumtaz.almansour@direct.lamaestra.nextgenshare.com

Organizations & group practices 6

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 6

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": "1182816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487203200000",
    "number": "1558567446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 S MAGNOLIA AVE",
            "address_2": "SUITE 101",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920205290",
            "telephone_number": "619-584-1612",
            "fax_number": "619-281-6738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 S MAGNOLIA AVE",
            "address_2": "SUITE 101",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920205290",
            "telephone_number": "619-584-1612",
            "fax_number": "619-281-6738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALMANSOUR",
        "first_name": "MUMTAZ",
        "middle_name": "THOMAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-26",
        "last_updated": "2017-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A55926",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A559261",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Cajon, CA

Sources for this page

Verify at the official NPI Registry.