Active NPI 1376506873 Individual Practitioner Male Practitioner

Dr. Sam Edward Mansour , MD

Ophthalmology • Warrenton, VA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. Sam Mansour, MD is a certified Ophthalmology practicing in Warrenton, VA. With approximately 40 years of clinical experience since completing medical education in 1986, Dr. Mansour delivers high-quality medical care to the local community at 45 N HILL DR STE 202.

Dr. Mansour maintains professional affiliations with Virginia Retina Center Llc, Medical Faculty Associates, Inc and accepts Medicare assignment.

Frequently performed procedures and clinical services include injection, faricimab-svoa, 0.1 mg, established patient outpatient office visit, imaging of retina. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

45 N Hill Dr Ste 202

Warrenton, VA 201862677

Telephone 5403491882

Fax 7037387157

Associated Practice Facility / Clinic

🏢 Virginia Retina Center Llc Facility NPI 1093869976

Medicare Profile & Education

Medical School

Other

Graduation Year

1986

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Ophthalmology in Warrenton, VA

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

40 Yrs +13.7 yrs vs City Avg

City Avg: 26.3 Yrs

State Avg: 28.6 Yrs

Regional Practice Density

4 Specialists

Practicing in Warrenton, VA (619 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

28.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Mansour (40 Years) 40 Yrs

Warrenton Specialty Average (26.3 Years) 26.3 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J2777 Injection, faricimab-svoa, 0.1 mg	14,886	57	$41.25	$34.68
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	2,207	962	$149.75	$123.78
92134 Imaging of retina	1,310	731	$52.97	$38.81
92250 Photography of the retina	1,186	823	$47.33	$35.68
J0177 Injection, aflibercept hd, 1 mg	928	43	$435.00	$325.93
67028 Injection of drug into eye	812	187	$133.53	$107.15
92202 Extended exam of the back part of the eye with optic nerve drawing	560	466	$20.25	$14.82
J0178 Injection, aflibercept, 1 mg	484	76	$1200.00	$822.97
99213 Established patient office or other outpatient visit, typically 15 minutes	220	193	$122.05	$88.89
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	131	131	$197.79	$162.05
92133 Imaging of optic nerve	101	96	$47.19	$34.68
J9035 Injection, bevacizumab, 10 mg	79	21	$100.96	$70.96
92201 Extended exam of the back part of the eye with retinal drawing	58	57	$34.66	$23.91
G2211 Visit complexity inherent to evaluation and management associated with medical care services that serve as the continuing focal point for all needed health care services and/or with medical care services that are part of ongoing care related to a patient's	53	53	$20.00	$15.84
92273 Full field recording of retinal electrical responses to external stimuli with interpretation and report	49	44	$147.96	$121.90
76512 Ultrasound of eye disease, growth, or structure	41	31	$61.46	$46.13
95930 Measurement of nerve conduction using visual stimulation testing with report	34	30	$77.21	$65.03
92083 Exam of visual field with extended testing	31	31	$80.81	$60.26
92014 Established patient complete exam of visual system	20	20	$300.00	$140.89
92235 Exam of retinal blood vessels using a special camera after injection of a dye	19	19	$175.84	$158.82
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	13	13	$67.69	$55.33
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	11	11	$200.73	$110.67

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J2777 Injection, faricimab-svoa, 0.1 mg	19,073	51	$40.00	$36.58
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	2,329	968	$149.59	$125.17
92134 Imaging of retina	1,380	730	$51.50	$39.56
92250 Photography of the retina	1,197	815	$46.37	$36.41
67028 Injection of drug into eye	881	163	$130.35	$110.06
J0178 Injection, aflibercept, 1 mg	767	75	$1149.73	$865.31
92202 Extended exam of the back part of the eye with optic nerve drawing	457	399	$20.06	$15.11
99213 Established patient office or other outpatient visit, typically 15 minutes	194	171	$121.60	$89.06
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	161	161	$197.33	$161.49
92133 Imaging of optic nerve	123	115	$47.01	$33.77
J9035 Injection, bevacizumab, 10 mg	86	26	$95.00	$71.22
92201 Extended exam of the back part of the eye with retinal drawing	73	70	$34.04	$23.84
92273 Full field recording of retinal electrical responses to external stimuli with interpretation and report	71	59	$148.04	$125.06
92083 Exam of visual field with extended testing	60	55	$73.66	$58.99
95930 Measurement of nerve conduction using visual stimulation testing with report	45	29	$74.00	$65.42
76512 Ultrasound of eye disease, growth, or structure	33	31	$59.16	$47.09
92235 Exam of retinal blood vessels using a special camera after injection of a dye	33	32	$163.63	$136.10
92242 Exam of retinal blood vessels and blood vessels between the white part of eye and retina using a special camera after injection of a dye	15	15	$278.73	$255.01

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J2777 Injection, faricimab-svoa, 0.1 mg	3,660	29	$40.00	$37.45
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	2,273	977	$149.25	$128.48
92134 Imaging of retina	1,385	749	$48.33	$40.75
J0178 Injection, aflibercept, 1 mg	1,104	115	$986.87	$896.78
92250 Photography of the retina	1,094	753	$46.09	$37.23
67028 Injection of drug into eye	883	173	$128.84	$112.24
92202 Extended exam of the back part of the eye with optic nerve drawing	430	403	$17.71	$15.69
J2778 Injection, ranibizumab, 0.1 mg	353	16	$400.00	$285.55
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	176	176	$192.09	$165.49
99213 Established patient office or other outpatient visit, typically 15 minutes	117	101	$110.86	$91.87
92133 Imaging of optic nerve	111	103	$41.13	$26.01
J9035 Injection, bevacizumab, 10 mg	79	24	$95.00	$68.42
92201 Extended exam of the back part of the eye with retinal drawing	73	71	$27.57	$24.13
92235 Exam of retinal blood vessels using a special camera after injection of a dye	61	59	$141.53	$126.95
92273 Full field recording of retinal electrical responses to external stimuli with interpretation and report	56	48	$143.18	$126.16
J3490 Unclassified drugs	45	17	$2502.22	$2204.77
76512 Ultrasound of eye disease, growth, or structure	43	32	$65.25	$48.43
92083 Exam of visual field with extended testing	42	39	$71.26	$61.06
95930 Measurement of nerve conduction using visual stimulation testing with report	31	26	$83.13	$64.47
92242 Exam of retinal blood vessels and blood vessels between the white part of eye and retina using a special camera after injection of a dye	29	28	$277.61	$252.55
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	12	12	$136.80	$112.55
67036 Removal of eye fluid (vitreous) between the lens and retina	12	12	$974.21	$791.21
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	11	11	$65.00	$56.64

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	2,067	844	$136.15	$130.43
92134 Imaging of retina	1,401	729	$48.16	$41.44
J0178 Injection, aflibercept, 1 mg	1,370	123	$992.23	$912.99
92250 Photography of the retina	987	674	$61.23	$39.57
67028 Injection of drug into eye	890	169	$127.42	$114.06
J2778 Injection, ranibizumab, 0.1 mg	545	20	$400.00	$315.41
92202 Extended exam of the back part of the eye with optic nerve drawing	448	421	$28.20	$15.98
99213 Established patient office or other outpatient visit, typically 15 minutes	177	151	$99.53	$92.77
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	129	129	$183.59	$168.15
92133 Imaging of optic nerve	113	105	$44.13	$25.42
92014 Established patient complete exam of visual system	110	80	$240.86	$139.88
92235 Exam of retinal blood vessels using a special camera after injection of a dye	69	63	$134.00	$118.80
92201 Extended exam of the back part of the eye with retinal drawing	54	53	$28.09	$25.00
J9035 Injection, bevacizumab, 10 mg	52	18	$103.94	$72.33
92273 Full field recording of retinal electrical responses to external stimuli with interpretation and report	50	48	$153.18	$130.76
92083 Exam of visual field with extended testing	46	41	$72.53	$62.75
76512 Ultrasound of eye disease, growth, or structure	41	34	$89.54	$49.72
92242 Exam of retinal blood vessels and blood vessels between the white part of eye and retina using a special camera after injection of a dye	32	29	$272.67	$248.32
95930 Measurement of nerve conduction using visual stimulation testing with report	22	20	$84.75	$68.39
67036 Removal of eye fluid (vitreous) between the lens and retina	12	11	$998.21	$725.75

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	2,056	922	$144.99	$128.36
92134 Imaging of retina	1,332	696	$48.57	$41.72
J0178 Injection, aflibercept, 1 mg	1,282	141	$986.67	$922.00
92250 Photography of the retina	897	645	$59.25	$45.28
67028 Injection of drug into eye	890	205	$118.34	$102.79
92202 Extended exam of the back part of the eye with optic nerve drawing	556	469	$28.44	$16.28
J2778 Injection, ranibizumab, 0.1 mg	442	21	$400.00	$334.02
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	126	126	$183.35	$165.70
J9035 Injection, bevacizumab, 10 mg	103	36	$97.50	$77.83
92235 Exam of retinal blood vessels using a special camera after injection of a dye	94	88	$127.68	$104.86
92133 Imaging of optic nerve	92	84	$43.03	$25.23
99213 Established patient office or other outpatient visit, typically 15 minutes	84	67	$87.29	$76.22
92201 Extended exam of the back part of the eye with retinal drawing	59	56	$30.83	$25.82
92012 Established patient problem focused exam of visual system	58	44	$98.45	$89.04
92273 Full field recording of retinal electrical responses to external stimuli with interpretation and report	40	39	$150.88	$133.08
92083 Exam of visual field with extended testing	39	36	$70.47	$64.19
76512 Ultrasound of eye disease, growth, or structure	37	28	$74.10	$53.42
92242 Exam of retinal blood vessels and blood vessels between the white part of eye and retina using a special camera after injection of a dye	34	32	$253.18	$243.00
G2012 Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m servic	22	20	$20.00	$14.64
95930 Measurement of nerve conduction using visual stimulation testing with report	19	17	$75.45	$68.02
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	16	15	$187.20	$112.76

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92014 Established patient complete exam of visual system	1,877	837	$141.56	$126.12
92226 Examination of eye by ophthalmoscope with retinal drawing	1,660	689	$34.49	$25.69
92134 Imaging of retina	1,312	728	$47.56	$41.25
J0178 Injection, aflibercept, 1 mg	998	97	$986.59	$929.48
92250 Photography of the retina	907	637	$60.93	$50.57
67028 Injection of drug into eye	701	150	$122.71	$101.41
J2778 Injection, ranibizumab, 0.1 mg	386	18	$400.00	$353.33
92225 Examination of eye by ophthalmoscope with retinal drawing	369	199	$31.44	$27.82
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	175	175	$183.08	$164.11
99213 Established patient office or other outpatient visit, typically 15 minutes	160	127	$90.07	$74.49
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	85	49	$237.16	$123.61
J9035 Injection, bevacizumab, 10 mg	83	25	$99.07	$79.02
92133 Imaging of optic nerve	65	61	$42.62	$28.21
92235 Exam of retinal blood vessels using a special camera after injection of a dye	50	50	$119.47	$92.95
92012 Established patient problem focused exam of visual system	44	36	$97.05	$88.51
92083 Exam of visual field with extended testing	40	37	$70.47	$64.13
92273 Full field recording of retinal electrical responses to external stimuli with interpretation and report	40	36	$147.06	$131.51
76512 Ultrasound of eye disease, growth, or structure	28	24	$93.94	$62.59
95930 Measurement of nerve conduction using visual stimulation testing with report	22	16	$75.45	$68.83
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	22	18	$57.66	$46.07
92242 Exam of retinal blood vessels and blood vessels between the white part of eye and retina using a special camera after injection of a dye	14	13	$253.18	$230.87

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92226 Examination of eye by ophthalmoscope with retinal drawing	2,475	829	$32.36	$24.84
92014 Established patient complete exam of visual system	1,743	802	$142.18	$124.30
92134 Imaging of retina	1,180	654	$50.05	$41.26
J0178 Injection, aflibercept, 1 mg	912	97	$989.74	$938.25
92250 Photography of the retina	865	630	$67.67	$55.61
67028 Injection of drug into eye	650	144	$126.03	$100.35
J2778 Injection, ranibizumab, 0.1 mg	294	14	$400.00	$368.68
92225 Examination of eye by ophthalmoscope with retinal drawing	287	157	$33.75	$26.93
99213 Established patient office or other outpatient visit, typically 15 minutes	187	152	$92.23	$73.31
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	120	120	$185.31	$161.93
92235 Exam of retinal blood vessels using a special camera after injection of a dye	100	91	$96.44	$85.59
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	84	59	$232.73	$118.35
J9035 Injection, bevacizumab, 10 mg	76	29	$93.15	$75.66
92133 Imaging of optic nerve	67	64	$43.15	$30.84
92083 Exam of visual field with extended testing	48	45	$70.63	$63.90
92275 Recording of retinal electrical responses to external stimuli	44	42	$171.55	$149.35
92242 Exam of retinal blood vessels and blood vessels between the white part of eye and retina using a special camera after injection of a dye	31	27	$255.44	$221.06
76512 Ultrasound of eye disease, growth, or structure	28	24	$140.75	$77.73
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	20	20	$135.88	$109.54
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	14	12	$50.25	$43.47
92012 Established patient problem focused exam of visual system	11	11	$96.27	$86.97

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92226 Examination of eye by ophthalmoscope with retinal drawing	3,274	941	$36.24	$24.45
92014 Established patient complete exam of visual system	1,979	909	$153.17	$122.35
92134 Imaging of retina	1,267	755	$70.65	$40.95
92250 Photography of the retina	889	663	$88.15	$65.02
J0178 Injection, aflibercept, 1 mg	678	79	$1034.04	$946.00
67028 Injection of drug into eye	592	141	$166.19	$99.07
92225 Examination of eye by ophthalmoscope with retinal drawing	381	227	$51.21	$26.92
99213 Established patient office or other outpatient visit, typically 15 minutes	228	180	$92.76	$73.80
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	132	132	$188.11	$164.22
92235 Exam of retinal blood vessels using a special camera after injection of a dye	117	106	$189.91	$77.73
J3590 Unclassified biologics	92	23	$100.82	$72.93
J9035 Injection, bevacizumab, 10 mg	83	38	$139.42	$66.43
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	79	66	$168.97	$118.33
92133 Imaging of optic nerve	67	58	$55.34	$31.06
92083 Exam of visual field with extended testing	64	60	$74.57	$62.41
92275 Recording of retinal electrical responses to external stimuli	58	55	$165.21	$144.98
92242 Exam of retinal blood vessels and blood vessels between the white part of eye and retina using a special camera after injection of a dye	47	37	$247.60	$223.02
76512 Ultrasound of eye disease, growth, or structure	27	21	$183.26	$96.38
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	23	19	$49.11	$43.55
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	20	20	$127.56	$104.89
67041 Removal of membrane from the retina	16	15	$1852.15	$1178.28
67036 Removal of eye fluid (vitreous) between the lens and retina	11	11	$1239.10	$935.64

Medical Specialties & State Licenses

CMS Verified: 2025-04-11

Ophthalmology Primary Specialty

NUCC Taxonomy Code: 207W00000X

State License VA 0101233782

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

Ophthalmology

NUCC Taxonomy Code: 207W00000X

State License CA A49545

Ophthalmology

NUCC Taxonomy Code: 207W00000X

State License MD D0059626

Ophthalmology

NUCC Taxonomy Code: 207W00000X

State License DC MD 34095

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

037331500 (DC)

Medicaid State Provider ID

010107067 (VA)

Medicaid State Provider ID

010107024 (VA)

Commercial Insurance / Payer ID Blue Cross Blue Shield

143213 (VA)

Hospital & Practice Group Affiliations

Virginia Retina Center Llc

18462 Crossroad Pkwy, Culpeper, VA 227014112

Phone: 7034430015

Medical Faculty Associates, Inc

2150 Pennsylvania Ave Nw, Washington, DC 200373201

Phone: 2027412600

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

5 Associated Practitioners

Dr. Lionel Chisholm , MD

Ophthalmology

NPI 1124094040

Doctor of Medicine (M.D.)

Dr. Alessa Crossan , MD

Ophthalmology - Retina Specialist

NPI 1477848034

Doctor of Medicine (M.D.)

Dr. Malkit Singh , MD MPA

Ophthalmology - Retina Specialist

NPI 1497175681

MDMPA

Dr. Alexandre Gauthier , MD

Ophthalmology

NPI 1710206057

Doctor of Medicine (M.D.)

Dr. Marena Patronas , MD

Ophthalmology

NPI 1992928352

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events

📍

Updated Practice Location April 11, 2025

Registered at 45 N HILL DR STE 202, WARRENTON, VA 201862677 (Tel: 5403491882)

📍

Updated Business Mailing Address April 11, 2025

Registered at 45 N HILL DR STE 202, WARRENTON, VA 201862677 (Tel: 5403491882)

✅

NPI Profile Active September 06, 2012

NPI status registered as active in NPPES database

📍

Updated Practice Location September 06, 2012

Registered at 20 ROCK POINTE LANE, SUITE 201, WARRENTON, VA 20186 (Tel: 7034430015)

📍

Updated Business Mailing Address September 06, 2012

Registered at 20 ROCK POINTE LN, SUITE 201, WARRENTON, VA 201862679 (Tel: 7034430015)

👤

Provider Name / Credentials Updated September 06, 2012

Recorded as SAM MANSOUR, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) September 06, 2012

Ophthalmology (License #0101233782 in VA)

🟢

Initial NPI Registration & Enumeration April 07, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1376506873

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: April 07, 2006

Last Update: April 11, 2025

Sole Proprietor: No

Update or Correct Profile

Mailing Address

45 N Hill Dr Ste 202

Warrenton, VA 201862677

Phone: 5403491882

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.