Individual provider Active NPI

Ahmad M. Mansury, M.D.

  • Ophthalmology Physician
  • Corona, CA
National Provider Identifier
1992960827
Registry record updated Apr 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
A100534 Issued in CA
Practice address
21634 Retreat Pkwy
Corona, CA 92883-6100
Phone
(951) 493-6934
Fax
(951) 826-8125
NPI assigned
Jul 21, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X A100534 CA Primary

Addresses

Primary practice location

21634 Retreat Pkwy
Corona, CA 92883-6100

Mailing address

21634 Retreat Pkwy
Corona, CA 92883-6100
Phone (951) 493-6934

Other practice location 1

3770 Keystone Avenue #210
Los Angeles, CA 90034
Phone (818) 640-9886

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20141125000376 CA Practitioner - Ophthalmology 3476682477 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of California, Geffen School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverside Medical Clinic IncGroup PAC ID 2961492327, 173 clinicians

Practice addresses (Care Compare)

6405 Day St
Riverside, CA 92507-0901
Phone (951) 697-5556

7117 Brockton Ave
Riverside, CA 92506-2658
Phone (951) 683-6370

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery43

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Medical Clinic, Inc Current Accepting new patients
Arthur J Edelstein M D a Professional Corporation Ophthalmology CurrentSince Jan 15, 2016 Accepting new patients
Riverside Medical Clinic, Inc CurrentSince Sep 1, 2019 Accepting new patients
Healthcare Partners Affiliates Medical Group Ophthalmology CurrentSince Oct 30, 2017 Accepting new patients
Healthcare Partners Affiliates Medical Group CurrentSince Oct 30, 2017 Accepting new patients
Riverside Medical Clinic, Inc Ophthalmology CurrentSince Sep 1, 2019 Accepting new patients
Doctors Hospital of Riverside LLC Past Accepting new patients
RMC Surgery Center, LLC Past Accepting new patients
Riverside Healthcare System, L.P. Past Accepting new patients

Locations

1236 N Magnolia Ave
Anaheim, CA 92801
Phone (714) 995-1000

824 E Carson St
Ste 104
Carson, CA 90745
Phone (310) 830-9706

315 N 3rd Ave
Ste 103
Covina, CA 91723
Phone (626) 859-2249

12742 Limonite Ave
Eastvale, CA 92880
Phone (951) 739-2712

3889 E Imperial Hwy
Lynwood, CA 90262
Phone (310) 638-0402

601 Torrance Blvd
#1182
Redondo Beach, CA 90277

3660 Arlington Ave
Riverside, CA 92506
Phone (951) 782-3789

6250 Clay St
Riverside, CA 92509
Phone (951) 360-5250

7160 Brockton Ave
Fl 2
Riverside, CA 92506
Phone (951) 782-3837

6405 Day St
Riverside, CA 92507
Phone (909) 683-6370

7160 Brockton Ave
Riverside, CA 92506
Phone (951) 782-3714

21634 Retreat Pkwy
Temescal Valley, CA 92883
Phone (951) 782-5157

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1216598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744588800000",
    "number": "1992960827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21634 RETREAT PKWY",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928836100",
            "telephone_number": "951-493-6934",
            "fax_number": "951-826-8125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21634 RETREAT PKWY",
            "city": "CORONA",
            "state": "CA",
            "postal_code": "928836100",
            "telephone_number": "951-493-6934",
            "fax_number": "951-826-8125"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3770 Keystone Avenue #210",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "90034",
            "country_code": "US",
            "telephone_number": "818-640-9886",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANSURY",
        "first_name": "AHMAD",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-21",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "A100534",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Corona, CA

Sources for this page

Verify at the official NPI Registry.