Timothy Wayne Mansouri, NURSE PRACTITIONER

Primary specialty

Pain Management Registered NurseTaxonomy code 163WP0000X

License

95003073 Issued in CA

Practice address

1600 Creekside Dr Ste 2400
Folsom, CA 95630-3485

Phone

(916) 932-4163

NPI assigned

Apr 16, 2015

Last updated

Mar 3, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Tim Mansouri Other name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Advanced Pain Diagnostic and Solutions IncGroup PAC ID 2264695196, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: timothy.mansouri.p1@direct.apdss.nextgenshare.com

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.

• Advanced Pain Diagnostic & Solutions, Inc.

  • Pain Clinic/Center
  • Roseville, CA
  • NPI 1427322635

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Bingtao Lin, MD, PC

  dba Ortho-Gen

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Roseville, CA
  • NPI 1750865358

  Single Specialty

  Medicare reassignment NPD

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

{
    "created_epoch": "1429142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583193600000",
    "number": "1770970899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8732 FLUTE CIR",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957571742",
            "telephone_number": "209-765-8297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 CREEKSIDE DR STE 2400",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303485",
            "telephone_number": "916-932-4163"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1665 Creekside Dr Ste 100",
            "address_purpose": "LOCATION",
            "city": "Folsom",
            "state": "CA",
            "postal_code": "956303538",
            "country_code": "US",
            "telephone_number": "916-932-4163",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANSOURI",
        "first_name": "TIMOTHY",
        "middle_name": "WAYNE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-16",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Pain Management",
            "state": "CA",
            "license": "656576",
            "primary": false
        },
        {
            "code": "163WP0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pain Management",
            "state": "CA",
            "license": "95003073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIM",
            "last_name": "MANSOURI",
            "credential": "NURSE PRACTITIONER",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Sonia Mann, PH.D.
• Indrani Manne, DDS
• Brittaney Elaine Manocchio
• Leah Mansfield, BCBA
• Linda M Mansker, CRNA
• Mantena Dental Corportation (Empire Parkway Dental Group)
• Rakesh Mantena, DDS
• Mavis Manthe
• Wendi Manuele, PHARM D
• Roger Mar-Tang, M.D.

• Registered Nurse in Folsom, CA
• Providers in Folsom, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; 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.