Jason Mansour, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

ME96393 Issued in FL

Practice address

1600 S. Andrews Avenue
Phoenix Emergency Medicine of Broward
Ft. Lauderdale, FL 33316

Phone

(954) 355-4400

NPI assigned

Oct 2, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Emergency Medicine

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Phoenix Emergency Medicine of Broward LLCGroup PAC ID 5991793002, 69 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Broward Health Medical Center Hospital, Fort Lauderdale, FL, CCN 100039

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Phoenix Emergency Medicine of Broward LLC

  • Emergency Medicine Physician
  • Coral Springs, FL
  • NPI 1871542969
  Medicare reassignment Care Compare group NPD
• Phoenix Emergency Medicine of Broward LLC

  • Emergency Medicine Physician
  • Deerfield Beach, FL
  • NPI 1407805591
  NPD

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

• North Broward Hospital District

  • General Acute Care Hospital
  • Fort Lauderdale, FL
  • NPI 1285662239
  Care Compare affiliation

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210723200000",
    "number": "1649364126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 S FORT LAUDERDALE BEACH BLVD",
            "address_2": "UNIT 705",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333161559",
            "telephone_number": "954-740-1505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 S. ANDREWS AVENUE",
            "address_2": "PHOENIX EMERGENCY MEDICINE OF BROWARD",
            "city": "FT. LAUDERDALE",
            "state": "FL",
            "postal_code": "33316",
            "telephone_number": "954-355-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOUR",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2008-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME96393",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "276227700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Manor Oaks, Inc.
• Manor Pines SNF Operations LLC
• Manor Plaza Pediatric & General Medicine Inc.
• Nandra D. Mansaram, CRNA
• Mansfieldcare LLC
• Jose Ignacio Mantilla, MD
• Manuel Diez, M.D., P.a.
• Gabriel Humberto Manzi, M.D.
• Karen Manzur Pineda, MD
• Map to Health LLC

• Emergency Medicine Physician in Ft. Lauderdale, FL
• Providers in Ft. Lauderdale, FL by specialty
• Emergency Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; 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.