Ramil Mansourov, M.D.

Primary specialty

Multi-Specialty GroupTaxonomy code 193200000X

License

040028 Issued in CT

Practice address

235 Main St
Norwalk, CT 06851-2720

Phone

(203) 644-4775

Fax

(203) 547-6118

NPI assigned

Apr 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Ramil Mansourov, LLC

  • Primary Care Clinic/Center
  • Norwalk, CT
  • NPI 1255583647
  NPD (past) Authorized official
• Aurora Urgent Care LLC

  • Clinic/Center
  • Grand Forks, ND
  • NPI 1942318308

  Multi-Specialty

  NPD (past)
• Center for Psychiatric Care

  • Psychiatry Physician
  • Grand Forks, ND
  • NPI 1043271885

  Multi-Specialty

  NPD (past)
• Northland Family Physicians LLC

  • Clinic/Center
  • Grand Forks, ND
  • NPI 1215990791

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466467200000",
    "number": "1992768477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 MAIN ST",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068512720",
            "telephone_number": "203-644-4775",
            "fax_number": "203-547-6118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 MAIN ST",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068512720",
            "telephone_number": "203-644-4775",
            "fax_number": "203-547-6118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSOUROV",
        "first_name": "RAMIL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-07",
        "last_updated": "2016-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ND",
            "license": "9376",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "KY",
            "license": "44050",
            "primary": false
        },
        {
            "code": "193200000X",
            "taxonomy_group": "",
            "desc": "Multi-Specialty",
            "state": "CT",
            "license": "040028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "26162",
            "state": "ND"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12543",
            "state": "ND"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Susan Whyte Mallozzi, NCC, LPC
• Lisa Ann Mandelman, LMFT
• Christopher Edward Manfredi, DO
• Rakhee Mangla, M.D.
• Amrik S Mann, RPH
• Jennifer Manto
• Leonardo Giuliano Marano, LCSW
• Marathon Healthcare of Norwalk
• Alison Ruth Marcell, LMSW
• Jeanne M Marconi, MD

• Multi-Specialty Group in Norwalk, CT
• Providers in Norwalk, CT by specialty
• Multi-Specialty Group in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.