DR. SAM EDWARD MANSOUR (MD) – Ophthalmology Physician, NPI 1376506873
Ophthalmology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
565 OPHTHALMOLOGY in VA
Provider Addresses for DR. SAM EDWARD MANSOUR (MD)
45 N HILL DR STE 202
WARRENTON, VA 201862677
Phone: (540) 349-1882
Fax: (703) 738-7157
Type: Mailing
20, Rock Pointe Lane, Warrenton, Fauquier County, Virginia, 20186, United States
SUITE 201
WARRENTON, VA 201862679
Phone: (703) 443-0015
Fax: (703) 738-7157
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 59 Open Payments records for all available years, with a total value of $42,120.
Total Amount is formed as General ($23,448) + Research ($18,672) + Ownership ($0) = $42,120.
Last reported payment date: 2024-12-19 • Largest payer in this snapshot: Iridex Corporation ($19,000).
Total Amount
$42,120
General + Research + Ownership
Payments
59
Total payment records
General Amount
$23,448
General payments
Research Amount
$18,672
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Iridex Corporation | $19,000 |
| Alimera Sciences, Inc. | $18,699 |
| EyePoint Pharmaceuticals US, Inc. | $2,625 |
| Astellas Pharma US Inc | $349 |
| Integra LifeSciences Corporation | $335 |
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: 2004-12-20
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20041123001305 | I | Ophthalmology | DC | TBD |
| I20041220000607 | I | Ophthalmology | VA | 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 |
|---|---|---|---|---|
| J2777 | Injection, faricimab-svoa, 0.1 mg | 19,073 | 51 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 2,329 | 968 | $0 |
| 92134 | Imaging of retina | 1,380 | 730 | $0 |
| 92250 | Photography of the retina | 1,197 | 815 | $0 |
| 67028 | Injection of drug into eye | 881 | 163 | $0 |
Insurance plans in this area (ZIP 20186)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Internal Medicine | DC | |
| O B S T E T R I C S/ G Y N E C O L O G Y | PA | |
| - | MD | |
| - | CA | |
| - | DC | |
| - | DC | |
| - | DC | |
| - | DC | |
| Physician Assistant | DC | |
| Critical Care (Intensivists), Internal Medicine | DC |
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