Active NPI
Mansoor Ahmed
- Podiatrist
- Brooklyn, NY
National Provider Identifier
1821442237
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 016005836
- Practice address
- 121 Dekalb Ave
House Staff Administration
Brooklyn, NY 11201-5425 - Phone
- (718) 250-8000
- NPI assigned
- Apr 21, 2016
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Podiatrist | 213E00000X | 016005836 | IL | Primary |
Addresses
Primary practice location
121 Dekalb Ave
House Staff Administration
Brooklyn, NY 11201-5425
Mailing address
404 Woodside Dr
Wood Dale, IL 60191-2535
Phone (630) 822-2445
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016005836 | IL | MD | Podiatrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| M & M Foot and Ankle Specialists PLLC | Current | Accepting new patients | |
| LS Home Health Wound Care Inc | Single Specialty | Current | Accepting new patients |
Organizations & group practices 4
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.
-
- Foot & Ankle Surgery Podiatrist
- Elgin, IL
- NPI 1467091066
-
- Family Nurse Practitioner
- Elmhurst, IL
- NPI 1245197862
Single Specialty
-
- Durable Medical Equipment & Medical Supplies
- Itasca, IL
- NPI 1083487623
-
- Nurse Practitioner
- Elk Grove Village, IL
- NPI 1871890657
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1567036800000",
"number": "1821442237",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "404 WOODSIDE DR",
"city": "WOOD DALE",
"state": "IL",
"postal_code": "601912535",
"telephone_number": "630-822-2445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "121 DEKALB AVE",
"address_2": "HOUSE STAFF ADMINISTRATION",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112015425",
"telephone_number": "718-250-8000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AHMED",
"first_name": "MANSOOR",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-04-21",
"last_updated": "2019-08-29",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "213E00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Podiatrist",
"state": "IL",
"license": "016005836",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.