Individual provider Active NPI

Mona E Mansour, MD

  • Pediatrics Physician
  • Cincinnati, OH
National Provider Identifier
1861420663
Registry record updated Dec 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
OH35067371 Issued in OH
Practice address
3333 Burnet Ave
ML 11032
Cincinnati, OH 45229-3026
Phone
(513) 636-8259
Fax
(513) 636-6419
NPI assigned
Jun 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X OH35067371 OH Primary

Addresses

Primary practice location

3333 Burnet Ave
ML 11032
Cincinnati, OH 45229-3026

Mailing address

3333 Burnet Ave
ML 11032
Cincinnati, OH 45229-3026
Phone (513) 636-8259

Other identifiers 1

IdentifierTypeStateIssuer
0997944MedicaidOH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050309000595 OH Practitioner - Pediatric Medicine 6608820964 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OH35067371OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Medical Center Pediatrics CurrentSince Jan 29, 2016 Accepting new patients
Montgomery Pediatrics Incorporated Past Accepting new patients
CHMC Community Health Services Network Pediatrics Past Accepting new patients

Locations

3341 Solutions Ctr
Chicago, IL 60677

335 Rockdale Ave
Cincinnati, OH 45229
Phone (513) 363-4700

2750 Beekman St
Cincinnati, OH 45225
Phone (513) 352-3192

3333 Burnet Ave
#5021
Cincinnati, OH 45229
Phone (513) 636-4225

3333 Burnet Ave
Cincinnati, OH 45229
Phone (513) 636-4200

3430 Burnet Ave
Ofc
Cincinnati, OH 45229
Phone (513) 636-7722

636 Prospect Pl
Cincinnati, OH 45229
Phone (513) 363-5500

3333 Burnet Ave
#11032
Cincinnati, OH 45229
Phone (513) 636-8259

2515 Clifton Ave
Cincinnati, OH 45219
Phone (513) 363-7554

3050 Mack Rd
Fairfield, OH 45014
Phone (513) 557-7718

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8872/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324944000000",
    "number": "1861420663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE",
            "address_2": "ML 11032",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-8259",
            "fax_number": "513-636-6419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BURNET AVE",
            "address_2": "ML 11032",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452293026",
            "telephone_number": "513-636-8259",
            "fax_number": "513-636-6419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOUR",
        "first_name": "MONA",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-29",
        "last_updated": "2011-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "OH35067371",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0997944",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

Verify at the official NPI Registry.