Individual provider Active NPI

Ashraf H Mansour, M.D.

  • Internal Medicine Physician
  • Elizabeth, NJ
National Provider Identifier
1952402398
Registry record updated Jan 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
25MA07692800 Issued in NJ
Practice address
240 Williamson St
Suite 400
Elizabeth, NJ 07202-3674
Phone
(908) 352-0560
Fax
(908) 352-4066
NPI assigned
Sep 26, 2006
Last updated
Jan 30, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 25MA07692800 NJ Primary

Addresses

Primary practice location

240 Williamson St
Suite 400
Elizabeth, NJ 07202-3674

Mailing address

240 Williamson St
Suite 400
Elizabeth, NJ 07202-3674
Phone (908) 352-0560

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20070123000517 NJ Practitioner - Internal MedicinePractitioner - Dermatology 2668473331 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Dermatology
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thalody Medical Associates LLCGroup PAC ID 1153662903, 3 clinicians

Practice addresses (Care Compare)

240 Williamson St
Elizabeth, NJ 07202-3672
Phone (908) 352-0560

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA07692800NJMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinitas Regional Medical Center Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: ashraf.mansour@direct.digidms.com

Organizations & group practices 2

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517270400000",
    "number": "1952402398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 WILLIAMSON ST",
            "address_2": "SUITE 400",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072023674",
            "telephone_number": "908-352-0560",
            "fax_number": "908-352-4066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 WILLIAMSON ST",
            "address_2": "SUITE 400",
            "city": "ELIZABETH",
            "state": "NJ",
            "postal_code": "072023674",
            "telephone_number": "908-352-0560",
            "fax_number": "908-352-4066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOUR",
        "first_name": "ASHRAF",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-26",
        "last_updated": "2018-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA07692800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabeth, NJ

Sources for this page

Verify at the official NPI Registry.