Dr Izzuddin Ali Mansur, MD is a medicare enrolled "Urology" physician in Crossville, Tennessee. He graduated from medical school in 1979 and has 45 years of diverse experience with area of expertise as Urology. He is a member of the group practice Covenant Medical Group Inc and his current practice location is
49 Cleveland St, Suite 220, Crossville, Tennessee. You can reach out to his office (for appointments etc.) via phone at
(931) 707-8050.
Dr Izzuddin Ali Mansur is licensed to practice in Tennessee (license number MD30604) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1508828344.
Physician's Profile
| Full Name | Dr Izzuddin Ali Mansur |
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| Gender | Male |
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| Speciality | Urology |
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| Experience | 45 Years |
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| Location | 49 Cleveland St, Crossville, Tennessee |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Izzuddin Ali Mansur graduated from medical school in 1979
NPI Data:
- NPI Number: 1508828344
- Provider Enumeration Date: 04/05/2006
- Last Update Date: 06/14/2021
Medicare PECOS Information:
- PECOS PAC ID: 3375630890
- Enrollment ID: I20071031000345
Medical Identifiers
Medical identifiers for Dr Izzuddin Ali Mansur such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1508828344 | NPI | - | NPPES |
| Q063406 | Medicaid | TN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208800000X | Urology | MD30604 (Tennessee) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Covenant Medical Group Inc | 2860305463 | 281 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Izzuddin Ali Mansur allows following entities to bill medicare on his behalf.
| Entity Name | Covenant Medical Group Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1457302010
PECOS PAC ID: 2860305463
Enrollment ID: O20060719000030 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Izzuddin Ali Mansur is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Izzuddin Ali Mansur, MD
49 Cleveland St, Suite 220,
Crossville, TN 38555-2855
Ph: (931) 707-8050 | Dr Izzuddin Ali Mansur, MD
49 Cleveland St, Suite 220,
Crossville, TN 38555-2855
Ph: (931) 707-8050 |
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