Imad M Mansoor, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

4301407249 Issued in MI

Practice address

42557 Woodward Ave Ste 110
Bloomfield Hills, MI 48304-5206

Phone

(248) 454-1004

Fax

(248) 332-9489

NPI assigned

Aug 27, 2006

Last updated

Mar 29, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MI

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

Internal Medicine

Education

Other, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Maan Ekkah MD PCGroup PAC ID 3870832785, 13 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health at Home- Southeast Michigan Home health agency, Livonia, MI, CCN 237069
• Trinity Health Oakland Hospital Hospital, Pontiac, MI, CCN 230029
• Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: imansoor32443@direct.trinity-health.org

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.

• Maan Ekkah MD PC

  • General Practice Physician
  • White Lake, MI
  • NPI 1114484540
  Medicare reassignment Care Compare group NPD
• Michigan Healthcare Professionals PC

  • Internal Medicine Physician
  • Farmington Hills, MI
  • NPI 1295023547
  Medicare reassignment NPD
• Imad Mansoor MD, PC

  • Internal Medicine Physician
  • Bloomfield Hills, MI
  • NPI 1821548181
  Authorized official Same address or phone
• Michigan Healthcare Professionals PC

  dba Urology Specialist of Michigan

  • Durable Medical Equipment & Medical Supplies
  • Lapeer, MI
  • NPI 1992693303
  NPD
• Cardiology and Vascular Associates PC

  dba Medical Care corporation

  • Family Nurse Practitioner
  • Bloomfield Hills, MI
  • NPI 1740473396
  NPD (past)
• Cardiology and Vascular Associates PC

  dba Medical Care Corporation

  • Internal Medicine Physician
  • Bloomfield Hills, MI
  • NPI 1962478743
  NPD (past)

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

• St Joseph Mercy Hospital-SMHC

  dba St Joseph Mercy Oakland

  • General Acute Care Hospital
  • Pontiac, MI
  • NPI 1053356352
  Care Compare affiliation
• Trinity Home Health Services

  dba St. Joseph Mercy Home Care

  • Home Health Agency
  • Livonia, MI
  • NPI 1508823774
  Care Compare affiliation
• William Beaumont Hospital

  dba Beaumont Hospital, Troy

  • General Acute Care Hospital
  • Troy, MI
  • NPI 1306825997
  Care Compare affiliation

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

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553817600000",
    "number": "1699883082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42557 WOODWARD AVE STE 130",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483045206",
            "telephone_number": "248-454-1004",
            "fax_number": "248-332-9489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42557 WOODWARD AVE STE 110",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483045206",
            "telephone_number": "248-454-1004",
            "fax_number": "248-332-9489"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "42557 Woodward Ave",
            "address_2": "Ste 130",
            "address_purpose": "LOCATION",
            "city": "Bloomfield Hills",
            "state": "MI",
            "postal_code": "483045206",
            "country_code": "US",
            "telephone_number": "248-322-3088 x257",
            "fax_number": "248-322-4175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANSOOR",
        "first_name": "IMAD",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-27",
        "last_updated": "2019-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301407249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE PTAN",
            "identifier": "MI4989",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL MEDICARE PTAN #",
            "identifier": "MI4898373",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4255895",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI TYPE II",
            "identifier": "1295023547",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Callie Manasco
• Minal Ashish Manek
• Julie Manning, PSY MALLP
• Violet Kim Manning
• George Nazar Mansoor
• Faiz Mansour, M.D.
• Yasser Mansour
• Maple Orthodontics, PLLC
• Carlo A Marceau, PA
• Sruti March, ND

• Internal Medicine Physician in Bloomfield Hills, MI
• Providers in Bloomfield Hills, MI by specialty
• Internal Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2019; 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.