Individual provider Active NPI

Leslie Barbara Mayro, M.D.

  • Internal Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1003829508
Registry record updated Feb 12, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD032149E Issued in PA
Practice address
2230 Cottman Ave
Health Care Center #10
Philadelphia, PA 19149-1230
Phone
(215) 685-0639
Fax
(215) 725-4877
NPI assigned
Aug 14, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD032149E PA Primary

Addresses

Primary practice location

2230 Cottman Ave
Health Care Center #10
Philadelphia, PA 19149-1230

Mailing address

500 S Broad St
Suite 360
Philadelphia, PA 19146-1613
Phone (215) 685-6769

Other identifiers 1

IdentifierTypeStateIssuer
0011336100008MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050510000885 PA Practitioner - Internal Medicine 3971543851 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Pittsburgh School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
City of PhiladelphiaGroup PAC ID 6305758723, 86 clinicians

Practice addresses (Care Compare)

4400 Haverford Ave
Philadelphia, PA 19104-1361
Phone (215) 685-7630

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
City of Philadelphia CurrentSince Jan 4, 2005 Accepting new patients
City of Philadelphia Past Accepting new patients

Locations

4400 Haverford Ave
#4
Philadelphia, PA 19104
Phone (215) 685-7600

2230 Cottman Ave
#10
Philadelphia, PA 19149
Phone (215) 685-0602

500 S Broad St
Ste 360
Philadelphia, PA 19146

4400 Haverford Ave
Philadelphia, PA 19104
Phone (215) 685-7504

1101 Market St
Fl 10
Philadelphia, PA 19107

Interoperability endpoints

  • Direct secure messaging: leslie.mayro@pdphahs.eclinicaldirectplus.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423699200000",
    "number": "1003829508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 S BROAD ST",
            "address_2": "SUITE 360",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191461613",
            "telephone_number": "215-685-6769",
            "fax_number": "215-685-6732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 COTTMAN AVE",
            "address_2": "HEALTH CARE CENTER #10",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191491230",
            "telephone_number": "215-685-0639",
            "fax_number": "215-725-4877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYRO",
        "first_name": "LESLIE",
        "middle_name": "BARBARA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-14",
        "last_updated": "2015-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD032149E",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011336100008",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.