NPIMap

Individual provider Active NPI

Nawar E Mansour, M.D.

  • Specialist
  • Memphis, TN
National Provider Identifier
1720077589
Registry record updated Feb 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
MD0000026012 Issued in TN
Practice address
1325 Eastmoreland Ave
Suite 335
Memphis, TN 38104-3519
Phone
(901) 726-1199
NPI assigned
Oct 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X MD0000026012 TN Primary

Addresses

Primary practice location

1325 Eastmoreland Ave
Suite 335
Memphis, TN 38104-3519

Mailing address

1325 Eastmoreland Ave
Suite 335
Memphis, TN 38104-3519
Phone (901) 726-1199

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051107001190 TN Practitioner - Nephrology 3577471812 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nephrology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kidney Specialists, P.C.Group PAC ID 6002808102, 2 clinicians

Practice addresses (Care Compare)

1325 Eastmoreland Ave
Memphis, TN 38104-3522
Phone (901) 726-1199

Hospital & facility affiliations

  • DaVita Renal Care of Memphis North Dialysis facility, Memphis, TN, CCN 442640
  • DaVita Whitehaven Renal Center Dialysis facility, Memphis, TN, CCN 442655
  • DaVita Singleton Farms Dialysis Dialysis facility, Memphis, TN, CCN 442753
  • DaVita Memphis Downtown Dialysis Dialysis facility, Memphis, TN, CCN 442682
  • DaVita Renal Care of Midtown Memphis Dialysis facility, Memphis, TN, CCN 442646
  • Methodist Hospitals of Memphis Hospital, Memphis, TN, CCN 440049
  • Baptist Memorial Hospital Tipton Hospital, Covington, TN, CCN 440131
  • Methodist Healthcare - Olive Branch Hospital Hospital, Olive Branch, MS, CCN 250167

Merit-based Incentive Payment System (MIPS)

Final score
65.21 of 100Reported as individual
Quality
83.15
Improvement activities
0
Cost
89.81

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD0000026012TNMDSpecialist
26012TNMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Kidney Specialists, P.C. Specialist CurrentSince Nov 1, 2000 Accepting new patients
Renal Treatment Centers-Southeast, LP. PastSince Feb 1, 2010 Accepting new patients

Locations

7318 Southcrest Pkwy
Southaven, MS 38671
Phone (662) 349-2548

1325 Eastmoreland Ave
Ste 335
Memphis, TN 38104
Phone (901) 726-0843

Interoperability endpoints

  • Direct secure messaging: nmansour31391@mlh.direct-ci.com
  • Direct secure messaging: nawar.mansour@direct.davitaphysiciansolutions.com

Organizations & group practices 2

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.

Hospital & facility affiliations 9

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": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328659200000",
    "number": "1720077589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 EASTMORELAND AVE",
            "address_2": "SUITE 335",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043519",
            "telephone_number": "901-726-1199",
            "fax_number": "701-726-0794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 EASTMORELAND AVE",
            "address_2": "SUITE 335",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043519",
            "telephone_number": "901-726-1199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOUR",
        "first_name": "NAWAR",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-14",
        "last_updated": "2012-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TN",
            "license": "MD0000026012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

Verify at the official NPI Registry.