| Mansoor Hussain Mirza, MD | |
|
2414 Kohler Memorial Drive, Sheboygan, WI 53081-3129 | |
| (920) 457-4461 | |
| (920) 459-1483 |
| Full Name | Mansoor Hussain Mirza |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Experience | 28 Years |
| Location | 2414 Kohler Memorial Drive, Sheboygan, Wisconsin |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508974502 | NPI | - | NPPES |
| P00138179 | Other | WI | NETWORK HEALTH PLAN |
| P00252461 | Other | WV | RAILROAD MEDICARE |
| 132679 | Other | WI | CIGNA |
| 390806395002 | Other | WI | TRICARE |
| 34652100 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 48060 (Wisconsin) | Primary |
| 208M00000X | Hospitalist | 48060 (Wisconsin) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| West Allis Memorial Hospital | West allis, WI | Hospital |
| Aurora Sheboygan Memorial Medical Ctr | Sheboygan, WI | Hospital |
| Aurora St Lukes Medical Center | Milwaukee, WI | Hospital |
| Aurora Medical Ctr Manitowoc County | Two rivers, WI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Aurora Medical Group, Inc. | 6709794258 | 3491 |
| Hackensack Meridian Health Medical Group - Specialty Care Pc | 9133032519 | 1587 |
| Entity Name | Aurora Medical Group, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1427271378 PECOS PAC ID: 6709794258 Enrollment ID: O20031105000725 |
| Entity Name | Impact Physician Group, Wisconsin Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1174291025 PECOS PAC ID: 2466840004 Enrollment ID: O20211101000625 |
| Mailing Address | Practice Location Address |
|---|---|
| Mansoor Hussain Mirza, MD 3600 Route 66 Fl 3, Neptune, NJ 07753-2645 Ph: (732) 807-0877 | Mansoor Hussain Mirza, MD 2414 Kohler Memorial Drive, Sheboygan, WI 53081-3129 Ph: (920) 457-4461 |
Gurminder Dhillon, MD Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 3100 Superior Ave, Sheboygan, WI 53081 Phone: 920-496-4700 Fax: 816-404-0003 | |
Dr. Philip M. Detrana, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 2414 Kohler Memorial Dr, Sheboygan, WI 53081 Phone: 920-457-4461 | |
Dr. Louie Coulis, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 1414 N Taylor Dr, Sheboygan, WI 53081 Phone: 920-458-9800 Fax: 920-458-9882 | |
Mr. Muhammad Rasheed Khan Orakzai, M.D. Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 3400 Union Ave, Sheboygan, WI 53081 Phone: 920-802-2100 | |
Sree Ramya Punukollu, Internal Medicine Medicare: Accepting Medicare Assignments Practice Location: 3400 Union Ave, Sheboygan, WI 53081 Phone: 920-802-2100 | |
Nathaniel Hitt, DO Internal Medicine Medicare: May Accept Medicare Assignments Practice Location: 3400 Union Ave, Sheboygan, WI 53081 Phone: 920-802-2100 Fax: 920-828-2705 | |
Dr. Rachael Bree Hosein, MBBS Internal Medicine Medicare: Medicare Enrolled Practice Location: 2414 Kohler Memorial Dr, Sheboygan, WI 53081 Phone: 920-457-4461 |