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Active NPI 1013159193 Individual Practitioner Male Practitioner

Mansuru Mustapha , PHYSICIAN ASSISTANT

Physician Assistant • Jblm, WA

Professional Overview & Biography Verified Profile Summary

Mansuru Mustapha, PHYSICIAN ASSISTANT is a registered healthcare professional specializing in Physician Assistant in Jblm, WA. Practice services are available at 9119 MIL PARK AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

9119 Mil Park Ave
Winder Clinic -Raider Clinic

Jblm, WA 984331100

Telephone 2534770800

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Jblm, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 9.0 Yrs
State Avg: 12.1 Yrs
Regional Practice Density
4 Specialists

Practicing in Jblm, WA (3774 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Practice Associates & Co-Workers

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

2 Associated Practitioners
Mitchell Marks , PA-C

Physician Assistant

NPI 1326594680

Physician Assistant (Certified)

Kevin Ludt , PA-C

Physician Assistant

NPI 1982319091

Physician Assistant (Certified)

Career & Practice History Timeline

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

6 Historical Events
NPI Profile Active May 30, 2013

NPI status registered as active in NPPES database

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Updated Practice Location May 30, 2013

Registered at 9119 MIL PARK AVE, WINDER CLINIC -RAIDER CLINIC, JBLM, WA 984331100 (Tel: 2534770800)

📍
Updated Business Mailing Address May 30, 2013

Registered at MADIGAN ARMY CENTER 9040 REID ST, ATTN: MCHJ-CLQ-C, TACOMA, WA 984311100 (Tel: 2539682252)

👤
Provider Name / Credentials Updated May 30, 2013

Recorded as MANSURU MUSTAPHA, PHYSICIAN ASSISTANT

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 30, 2013

Physician Assistant

🟢
Initial NPI Registration & Enumeration April 03, 2009

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1013159193
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 03, 2009
Last Update: May 30, 2013
Sole Proprietor: No

Mailing Address

Madigan Army Center 9040 Reid St, Attn: Mchj-Clq-C

Tacoma, WA 984311100

Phone: 2539682252

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.