Mohammad Tariq Ansari, M.D.
Individual provider Active NPI Pulmonary Disease Physician · Greenville, SC
NPI 1821047044 · NPPES record last updated Jul 19, 2021
Key facts
- NPI
- 1821047044
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pulmonary Disease Physician 207RP1001X
- License
- 15259 (SC)
- Practice address
- 200 Patewood Dr
Suite B480
Greenville, SC 29615-3593 - Phone
- (864) 454-4200
- Fax
- (864) 454-4205
- NPI assigned
- May 6, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 54
Medicare Care Compare profile
- Specialty
- Pulmonary Disease
- Education
- Other, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Prisma Health University Medical Group
Practice addresses (Care Compare)
125 Professional Park Dr
Seneca, SC 29678-2558
Phone (864) 482-3000
135 Professional Park Dr
Seneca, SC 29678-2558
Phone (864) 882-5306
200 Fleetwood Dr
Easley, SC 29640-2022
Phone (864) 442-7618
200 Patewood Dr
Suite B300
Greenville, SC 29615-6338
Phone (864) 454-4200
210 Freeman Farm Rd
Duncan, SC 29334-9398
Phone (864) 968-5123
22725 Hwy 76 E
Clinton, SC 29325-7527
Phone (864) 833-4545
22725 US Hwy 76
Suite 3C
Clinton, SC 29325-7527
Phone (864) 833-3852
300 E McBee Ave
Greenville, SC 29601-2842
Phone (864) 797-6220
300 E McBee Ave FL
Suite 4
Greenville, SC 29601-2842
315 Medical Pkwy
Greer, SC 29650-2456
701 Grove Rd
Greenville, SC 29605-4210
890 W Faris Rd
Suite 570
Greenville, SC 29605-5894
Phone (864) 455-1540
Hospital & facility affiliations
- Prisma Health Greenville Memorial Hospital
- Prisma Health Baptist Easley Hospital
- Prisma Health Greer Memorial Hospital
- Prisma Health Laurens County Hospital
- Prisma Health Patewood Hospital
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050921001019 | SC | Practitioner - Pulmonary Disease |
6204860059 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prisma Health University Medical Group | Current |
Accepting new patients | |
| Greenville Health System | Current | Accepting new patients | |
| Prisma Health University Medical Group | Current | Accepting new patients | |
| Prisma Health University Medical Group | Current |
Accepting new patients | |
| Greenville Health System | Current |
Accepting new patients | |
| Greenville Proaxis Therapy, LLC | Past | Accepting new patients |
Locations
22725 US Highway 76
Clinton, SC 29325
Phone (864) 833-9100
210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123
100 Augusta St
Greenville, SC 29601
Phone (864) 455-2600
2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761
200 Patewood Dr
Ste B480
Greenville, SC 29615
Phone (864) 454-4200
200 Patewood Dr
Ste B300
Greenville, SC 29615
Phone (864) 454-4200
701 Grove Rd
Greenville, SC 29605
Phone (864) 454-2030
890 W Faris Rd
Ste 320
Greenville, SC 29605
Phone (864) 455-1200
1 Independence Pt
Ste 212
Greenville, SC 29615
Phone (864) 797-6306
300 E McBee Ave
Fl 4
Greenville, SC 29601
Phone (864) 522-8615
200 Patewood Dr
Bldg A
Greenville, SC 29615
Phone (864) 454-2604
315 Medical Pkwy
Ste 200
Greer, SC 29650
Phone (864) 797-9550
719A SE Main St
Simpsonville, SC 29681
Phone (864) 967-9000
807 N Main St
Travelers Rst, SC 29690
Phone (864) 834-5132
Interoperability endpoints
- mansari7095@direct.ghs.myhfn.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine (Internal Medicine) Physician | 207RC0200X | 15259 | SC | |
| Sleep Medicine (Internal Medicine) Physician | 207RS0012X | 15259 | SC | |
| Pulmonary Disease Physician | 207RP1001X | 15259 | SC | Yes |
Addresses
Primary practice location
200 Patewood Dr
Suite B480
Greenville, SC 29615-3593
Mailing address
300 E McBee Ave FL 4
Greenville, SC 29601-2842
Phone (864) 522-8611
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 290010760 | Other | SC | RR MEDICARE |
| 152596 | Medicaid | SC |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mansari7095@direct.ghs.myhfn.org | Direct |
NPI Registry JSON
{
"created_epoch": "1146873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626652800000",
"number": "1821047044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 E MCBEE AVE FL 4",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296012842",
"telephone_number": "864-522-8611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 PATEWOOD DR",
"address_2": "SUITE B480",
"city": "GREENVILLE",
"state": "SC",
"postal_code": "296153593",
"telephone_number": "864-454-4200",
"fax_number": "864-454-4205"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANSARI",
"first_name": "MOHAMMAD",
"middle_name": "TARIQ",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-06",
"last_updated": "2021-07-19",
"certification_date": "2021-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "207RC0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Critical Care Medicine",
"state": "SC",
"license": "15259",
"primary": false
},
{
"code": "207RS0012X",
"taxonomy_group": "",
"desc": "Internal Medicine, Sleep Medicine",
"state": "SC",
"license": "15259",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "SC",
"license": "15259",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "290010760",
"state": "SC"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "152596",
"state": "SC"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mansari7095@direct.ghs.myhfn.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "mansari7095@direct.ghs.myhfn.org",
"address_1": "200 Patewood Dr",
"address_2": "Suite B480",
"city": "Greenville",
"state": "SC",
"country_code": "US",
"postal_code": "296153593",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 19, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.