Waleed Mansour, M.DL

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

35078230M Issued in OH

Practice address

1397 S Canfield Niles Rd
Unit 1
Austintown, OH 44515-4084

Phone

(330) 953-0129

Fax

(330) 953-0650

NPI assigned

Dec 16, 2005

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Brown Memorial Hospital

  • Emergency Medicine Physician
  • Conneaut, OH
  • NPI 1447330519
  NPD (past)
• Mahoning Valley Emergency Specialists LLC

  • Emergency Medicine Physician
  • Youngstown, OH
  • NPI 1003869652
  NPD (past)

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

{
    "created_epoch": "1134691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1740266352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1397 S CANFIELD NILES RD",
            "address_2": "UNIT 1",
            "city": "AUSTINTOWN",
            "state": "OH",
            "postal_code": "445154084",
            "telephone_number": "330-953-0129",
            "fax_number": "330-953-0650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1397 S CANFIELD NILES RD",
            "address_2": "UNIT 1",
            "city": "AUSTINTOWN",
            "state": "OH",
            "postal_code": "445154084",
            "telephone_number": "330-953-0129",
            "fax_number": "330-953-0650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOUR",
        "first_name": "WALEED",
        "credential": "M.DL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-16",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "35078230M",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENNSYLVANIA MEDICAID",
            "identifier": "181396874-0001",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2254180",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00164262",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ginamarie Malleske, PHARMD
• John Manenti, DO
• Mary Louise Mangie
• Malayiia Mann
• Steven Manna
• Marc Glassman Inc
• Alexis Marcoe, PEER SUPPORTER
• Tara Marsh
• Christopher A Martin, LPN
• Ivorie Martin

• Emergency Medicine Physician in Austintown, OH
• Providers in Austintown, OH by specialty
• Emergency Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.