MANSOUR ELTAHER KHADDR (M.D.) – Cardiovascular Disease Physician, NPI 1124384797
Cardiovascular Disease Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
31 CARDIOVASCULAR DISEASE (CARDIOLOGY) in WY
Provider Addresses for MANSOUR ELTAHER KHADDR (M.D.)
428 S DURBIN ST STE 104
CASPER, WY 826012829
Phone: (307) 337-4284
Fax: (307) 224-3436
Type: Mailing
1453A DEWAR DR
ROCK SPRINGS, WY 829015812
Phone: (307) 382-2466
Fax: (888) 395-0359
Type: Location
1204 HILLTOP DR STE 106
ROCK SPRINGS, WY 829015861
Phone: (307) 522-5555
Fax: (888) 819-5155
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 9 Open Payments records for all available years, with a total value of $180.
Total Amount is formed as General ($180) + Research ($0) + Ownership ($0) = $180.
Last reported payment date: 2024-12-21 • Largest payer in this snapshot: Boston Scientific Corporation ($164).
Total Amount
$180
General + Research + Ownership
Payments
9
Total payment records
General Amount
$180
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-21
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Boston Scientific Corporation | $164 |
| E.R. Squibb & Sons, L.L.C. | $16 |
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: 2020-06-29
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 |
|---|---|---|---|---|
| I20200629003746 | I | Cardiovascular Disease (Cardiology) | WY | 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 |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 1,017 | 476 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 626 | 370 | $0 |
| 93000 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report | 539 | 406 | $0 |
| J2785 | Injection, regadenoson, 0.1 mg | 340 | 85 | $0 |
| A9500 | Technetium tc-99m sestamibi, diagnostic, per study dose | 220 | 110 | $0 |
Insurance plans in this area (ZIP 82601)
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