Individual provider Active NPI

Mossammat Mosfeka Mansur, M.D

  • Infectious Disease Physician
  • Hempstead, NY
National Provider Identifier
1609856889
Registry record updated Sep 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
234659 Issued in NY
Practice address
230 Hilton Ave
Suite # 18
Hempstead, NY 11550-8115
Phone
(516) 565-5200
NPI assigned
Jan 22, 2006
Last updated
Sep 24, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 234659 NY
Infectious Disease Physician 207RI0200X 234659 NY Primary

Addresses

Primary practice location

230 Hilton Ave
Suite # 18
Hempstead, NY 11550-8115

Mailing address

230 Hilton Ave
Suite # 18
Hempstead, NY 11550-8115
Phone (516) 565-5200

Other identifiers 1

IdentifierTypeStateIssuer
02630422MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20051216000043 NY Practitioner - Infectious DiseasePractitioner - Internal Medicine 0143241372 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
TBHC Physician Services PCGroup PAC ID 9133265317, 111 clinicians

Practice addresses (Care Compare)

121 Dekalb Ave
Brooklyn, NY 11201-5425
Phone (718) 250-8000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
TBHC Physician Services PC Infectious Disease CurrentSince Feb 15, 2017 Accepting new patients

Locations

121 DeKalb Ave
Brooklyn, NY 11201
Phone (718) 250-6604

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: mmansur8745@prd.direct.tbh.org

Organizations & group practices 1

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": "1137888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411516800000",
    "number": "1609856889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 HILTON AVE",
            "address_2": "SUITE # 18",
            "city": "HEMPSTEAD",
            "state": "NY",
            "postal_code": "115508115",
            "telephone_number": "516-565-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 HILTON AVE",
            "address_2": "SUITE # 18",
            "city": "HEMPSTEAD",
            "state": "NY",
            "postal_code": "115508115",
            "telephone_number": "516-565-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSUR",
        "first_name": "MOSSAMMAT",
        "middle_name": "MOSFEKA",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-22",
        "last_updated": "2014-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "234659",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "NY",
            "license": "234659",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02630422",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hempstead, NY

Sources for this page

Verify at the official NPI Registry.