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TIMOTHY WAYNE MANSOURI NURSE PRACTITIONER
NPI 1770970899
Registered Nurse - Pain Management in Folsom, CA

Active since April 16, 2015PECOS EnrolledAccepts Medicare Assignment
1600 CREEKSIDE DR STE 2400, FOLSOM, CA 95630(916) 932-4163 Get Directions Write a Review

NPPES record last updated: March 3, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Mar 3, 2020, Apr 28, 2017 (2 updates tracked since 2017).

About Timothy Wayne Mansouri Nurse Practitioner NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TIMOTHY WAYNE MANSOURI NURSE PRACTITIONER (NPI 1770970899) is an individual pain management provider in Folsom, California, licensed in California (95003073) and active in the NPI registry since April 2015. He is enrolled in Medicare PECOS, maintains a secondary practice location in Folsom, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1770970899
Entity TypeIndividualMale
Primary Taxonomy163WP0000X
Provider Legal NameTIMOTHY WAYNE MANSOURICredential: NURSE PRACTITIONER
Location Address1600 CREEKSIDE DR STE 2400Folsom, CA 95630-3485
Mailing Address8732 Flute CirElk Grove, CA 95757-1742 · (209) 765-8297
Phone(916) 932-4163
Sole ProprietorYes
Medical School CMSOtherGraduated 2015
Enumeration DateApril 16, 2015
Last NPPES UpdateMarch 3, 20202 updates tracked since enumeration
NPPES CertifiedMarch 3, 2020
✔ NPI 1770970899 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRegistered Nurse · Pain ManagementNursing Service Providers
Taxonomy Code163WP0000X
Licenses✔ Licensed in CA · 95003073✔ Licensed in CA · 656576
1600 CREEKSIDE DR STE 2400, Folsom, CA 95630
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Other Names 1

Other Name (5)Tim Mansouri Nurse Practitioner

Secondary Practice Location 1

Location 11665 Creekside Dr Ste 100Folsom, CA 95630-3538 · Phone (916) 932-4163

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Timothy Wayne Mansouri Nurse Practitioner is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5890120976
PECOS Enrollment IDI20200305002283
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show Timothy Mansouri reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Advanced Pain Diagnostic & Solutions, Inc.
8.0 mi
Pain
729 SUNRISE AVE STE 602
Roseville, CA 95661
  • Reassigned Medicare billing, California enrollment
  • 26 clinicians in this Medicare group
NPI 1427322635 (916) 953-7571
Bingtao Lin, MD, PC
8.0 mi
Pain Medicine
729 SUNRISE AVE STE 503
Roseville, CA 95661
  • Reassigned Medicare billing, California enrollment
  • 9 clinicians in this Medicare group
NPI 1750865358 (916) 932-4163

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
1,344 services447 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
904 services440 patients
Drug test(s), definitive, utilizing (1) drug identification methods able to identify individual drugs and distinguish between structural isomers (but not necessarily stereoisomers), including, but not limited to gc/ms (any type, single or tandem) and lc/ms G0481
A definitive drug test is a detailed analysis used to identify specific drugs in your system. It uses advanced techniques, such as gc/ms and lc/ms, to detect and distinguish between different drugs, even those with similar structures.
459 services312 patients
Testing for presence of drug, by chemistry analyzers 80307
Chemistry analyzers are used to detect the presence of drugs in your system. This test involves taking a small sample of your blood or urine. The sample is then analyzed for specific substances. The results help in understanding your health condition better.
413 services293 patients
Testing for presence of drug, read by direct observation 80305
Testing for the presence of drugs involves collecting a sample, usually urine, which is then analyzed for specific substances. The process is monitored directly to ensure accuracy and integrity. This test helps to confirm if drugs are present in your system.
121 services107 patients

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Timothy Mansouri's NPI number?

The NPI number for Timothy Mansouri is 1770970899. It was assigned to this individual provider in the NPPES registry on April 16, 2015. The provider is also known as Tim Mansouri Nurse Practitioner.

Where is Timothy Mansouri located?

Timothy Mansouri practices at 1600 Creekside Dr Ste 2400, Folsom, CA 95630. The listed phone number is (916) 932-4163.

What is Timothy Mansouri's specialty?

The primary specialty registered for this NPI is Registered Nurse, specializing in Pain Management, with taxonomy code 163WP0000X.

Is Timothy Mansouri enrolled in Medicare?

Yes. Timothy Mansouri is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Timothy Mansouri's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Timothy Mansouri reassigns Medicare benefits to 2 organizations: Advanced Pain Diagnostic & Solutions, Inc. (Roseville, CA) and Bingtao Lin, MD, PC (Roseville, CA). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Timothy Mansouri's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Timothy Mansouri was last updated on March 3, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.