Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ghassem Mangouri, MD

Individual provider Surgery Physician · NPI 1134119209

Ghassem Mangouri, MD is a General Surgery in Johnson City, New York. Qualified in 1973, 53 years ago. Practices with Our Lady of Lourdes Memorial Hospital Inc, a 249-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
53
Licensed in
NY
In the registry since
2005
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

355 Riverside Dr
Johnson City, NY 13790-2708
Phone: (607) 798-0706
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 154223 (NY)

Record details

NPI number1134119209
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 28, 2005
Last updated in NPPESJuly 8, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGENERAL SURGERY
Medical schoolOTHER
Graduated 1973 (53 years in practice)
Group practice Our Lady Of Lourdes Memorial Hospital Inc — 249 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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