Individual provider Active NPI

Mahsaw Mansoor, MD

  • Ophthalmology Physician
  • Ann Arbor, MI
National Provider Identifier
1598389926
Registry record updated Jul 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
4301510919 Issued in MI
Practice address
1000 Wall St
Ann Arbor, MI 48105-1912
Phone
(734) 764-4190
NPI assigned
Jun 1, 2020
Last updated
Jul 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X R-11895 IA
Ophthalmology Physician 207W00000X 4301510919 MI Primary
Ophthalmology Physician 207W00000X R-11895 IA

Addresses

Primary practice location

1000 Wall St
Ann Arbor, MI 48105-1912

Mailing address

3621 S State St
Ann Arbor, MI 48108-1633
Phone (734) 647-5299

Other practice location 1

200 Hawkins Dr Dept Of
Iowa City, IA 52242-1009
Phone (216) 337-3768

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mahsaw-motlagh@uiowa.edu

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, CA2 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

Enrollment IDStateProvider typePAC IDDetails
I20240821003165 MI Practitioner - Ophthalmology 9638593114 Reassigns benefits to 1 organization
I20250528002745 CA Practitioner - Ophthalmology 9638593114 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Arizona College of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Vision Care a California General PartnershipGroup PAC ID 1658553722, 5 clinicians

Practice addresses (Care Compare)

2080 Century Park E
Suite 911
Los Angeles, CA 90067-2012
Phone (310) 229-1220

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301510919MIMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Vision Care a California General Partnership Ophthalmology CurrentSince Jul 1, 2025 Accepting new patients
Regents of the University of Michigan Ophthalmology CurrentSince Jul 1, 2024 Accepting new patients
Regents of the University of Michigan CurrentSince Jul 1, 2024 Accepting new patients

Locations

2080 Century Park E
Ste 911
Los Angeles, CA 90067
Phone (310) 229-1220

1000 Wall St
Ann Arbor, MI 48105
Phone (734) 763-1415

3621 S State St
Ann Arbor, MI 48108
Phone (734) 647-5229

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1590969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720396800000",
    "number": "1598389926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 WALL ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481051912",
            "telephone_number": "734-764-4190"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Hawkins Dr Dept Of",
            "address_purpose": "LOCATION",
            "city": "Iowa City",
            "state": "IA",
            "postal_code": "522421009",
            "country_code": "US",
            "telephone_number": "216-337-3768",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANSOOR",
        "first_name": "MAHSAW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-01",
        "last_updated": "2024-07-08",
        "certification_date": "2024-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IA",
            "license": "R-11895",
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MI",
            "license": "4301510919",
            "primary": true
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IA",
            "license": "R-11895",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mahsaw-motlagh@uiowa.edu",
            "affiliation": "N",
            "endpointDescription": "Email",
            "address_1": "200 Hawkins Dr Dept Of",
            "city": "Iowa City",
            "state": "IA",
            "country_code": "US",
            "postal_code": "522421009",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.