DR. SAMRAH MANSOOR (MD) – Family Medicine Physician, NPI 1063581809
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
13,194 FAMILY PRACTICE in CA
Provider Addresses for DR. SAMRAH MANSOOR (MD)
27522 Antonio Pkwy Ste P3
Ladera Ranch, CA 926942166
Phone: (949) 207-3786
Type: Location
1711 W Katella Ave
Anaheim, CA 928046450
Phone: (714) 400-2959
Type: Location
3161, North Rock Road, Wichita, Sedgwick County, Kansas, 67226, United States
SUITE C
WICHITA, KS 672261312
Phone: (316) 440-2713
Fax: (316) 260-6897
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-06-30
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20070613000038 | I | Family Practice | MO | TBD |
| I20140327002075 | I | Family Practice | KS | TBD |
| I20230515003052 | I | Family Practice | NE | TBD |
| I20250630004290 | I | Family Practice | CA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 532 | 56 | $0 |
| 96372 | Injection of drug or substance under skin or into muscle | 74 | 63 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 71 | 71 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 64 | 59 | $0 |
| 87811 | Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) | 40 | 40 | $0 |
Insurance plans in this area (ZIP 92694)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | NE | |
| Physician Assistant | NE | |
| Nurse Practitioner | NE | |
| - | NE | |
| General Practice | NE | |
| Physician Assistant | NE | |
| - | NE | |
| Nurse Practitioner | KS | |
| Physician Assistant | CT | |
| Nurse Practitioner | NE |
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