ANISSA MANSOORI (PA-C) – Physician Assistant, NPI 1356861975
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
10,570 PHYSICIAN ASSISTANT in CA
Provider Addresses for ANISSA MANSOORI (PA-C)
31655 Coast Hwy Ste A
Laguna Beach, CA 926517019
Phone: (949) 545-6605
Fax: (949) 326-7509
Type: Location
141 N VIEW LN NW
KENNESAW, GA 301441456
Phone:
Type: Mailing
141 LACY ST NW STE 200
MARIETTA, GA 300601118
Phone: (770) 426-7177
Type: Location
27800 MEDICAL CENTER RD STE 220
MISSION VIEJO, CA 926916408
Phone: (949) 545-6605
Fax: (949) 326-7509
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 47 Open Payments records for all available years, with a total value of $1,795.
Total Amount is formed as General ($1,795) + Research ($0) + Ownership ($0) = $1,795.
Last reported payment date: 2024-12-24 • Largest payer in this snapshot: Incyte Corporation ($527).
Total Amount
$1,795
General + Research + Ownership
Payments
47
Total payment records
General Amount
$1,795
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-24
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Incyte Corporation | $527 |
| Galderma Laboratories, L.P. | $302 |
| ABBVIE INC. | $298 |
| PFIZER INC. | $151 |
| Lilly USA, LLC | $128 |
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: 2020-05-26
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
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 |
|---|---|---|---|---|
| I20200526003064 | I | Physician Assistant | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 20 | 19 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 15 | 15 | $0 |
| 17110 | Destruction of skin growth, 1-14 growths | 12 | 11 | $0 |
Insurance plans in this area (ZIP 92651)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P O D I A T R Y | CA | |
| D E R M A T O L O G Y | CA |
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