Individual provider Active NPI

Mohammed Mansaray, DPT

  • Physical Therapist
  • Rancho Palos Verdes, CA
National Provider Identifier
1629868948
Registry record updated May 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
28924 S Western Ave Ste 101
Rancho Palos Verdes, CA 90275-0813
Phone
(310) 548-0104
NPI assigned
May 9, 2025
Last updated
May 9, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

28924 S Western Ave Ste 101
Rancho Palos Verdes, CA 90275-0813

Mailing address

28924 S Western Ave Ste 101
Rancho Palos Verdes, CA 90275-0813
Phone (310) 548-0104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250528002956 CA Practitioner - Physical Therapist in Private Practice 7214456631 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
California Luna Care Physical Therapy PCGroup PAC ID 9638427834, 769 clinicians

Practice addresses (Care Compare)

Los Gatos, CA 95032
Phone (866) 525-3175

28924 S Wester Ave
Suite 101
Rancho Palos Verdes, CA 90275-0813
Phone (310) 548-0104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Prosport Physical Therapy Professionals Inc Physical Therapist CurrentSince May 11, 2025 Accepting new patients
Prosport Physical Therapy Professionals Inc Physical Therapist CurrentSince May 9, 2025 Accepting new patients
Prosport Physical Therapy Professionals Inc Physical Therapist CurrentSince May 9, 2025 Accepting new patients

Locations

26672 Portola Pkwy
Ste 116
Foothill Rnch, CA 92610
Phone (714) 450-4999

28924 S Western Ave
Ste 101
Rch Palos Vrd, CA 90275
Phone (310) 548-0101

Organizations & group practices 4

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": "1746748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746748800000",
    "number": "1629868948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28924 S WESTERN AVE STE 101",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902750813",
            "telephone_number": "310-548-0104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28924 S WESTERN AVE STE 101",
            "city": "RANCHO PALOS VERDES",
            "state": "CA",
            "postal_code": "902750813",
            "telephone_number": "310-548-0104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSARAY",
        "first_name": "MOHAMMED",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-05-09",
        "last_updated": "2025-05-09",
        "certification_date": "2025-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Palos Verdes, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.