Individual provider Active NPI

Sana Mansoor, M.D

  • Pediatric Gastroenterology Physician
  • Baltimore, MD
National Provider Identifier
1912253121
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X
License
D008545 Issued in MD
Practice address
2411 W Belvedere Ave Ste 407
Baltimore, MD 21215-5231
Phone
(410) 601-8663
Fax
(410) 601-5389
NPI assigned
Jul 25, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Gastroenterology Physician 2080P0206X D008545 MD Primary

Addresses

Primary practice location

2411 W Belvedere Ave Ste 407
Baltimore, MD 21215-5231

Mailing address

9500 Euclid Ave
Cleveland, OH 44195-0001

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address smansoor@direct.lifebridgehealth.org Sinai Hospital of Baltimore, Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20180827001657 MD Practitioner - Pediatric Medicine 4880943760 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D008545MDMDPediatric Gastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sinai Hospital of Baltimore Inc Pediatric Gastroenterology CurrentSince Sep 1, 2018 Accepting new patients
Sinai Hospital of Baltimore, Inc. CurrentSince Sep 1, 2018 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

2411 W Belvedere Ave
Ste 407
Baltimore, MD 21215
Phone (410) 601-8663

Interoperability endpoints

  • Direct secure messaging: smansoor@direct.lifebridgehealth.org

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": "1343174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1912253121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 EUCLID AVE",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441950001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2411 W BELVEDERE AVE STE 407",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212155231",
            "telephone_number": "410-601-8663",
            "fax_number": "410-601-5389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOOR",
        "first_name": "SANA",
        "name_prefix": "Miss",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-25",
        "last_updated": "2023-11-27",
        "certification_date": "2020-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "MD",
            "license": "D008545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "smansoor@direct.lifebridgehealth.org",
            "affiliation": "Y",
            "affiliationName": "Sinai Hospital of Baltimore, Inc",
            "address_1": "2411 W Belvedere Ave Ste 407",
            "city": "Baltimore",
            "state": "MD",
            "country_code": "US",
            "postal_code": "212155231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.