Individual provider Active NPI

Leslie A Pittman, MD

  • Family Medicine Physician
  • Statesboro, GA
National Provider Identifier
1013245091
Registry record updated Feb 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
076411 Issued in GA
Practice address
16741 Hwy 67
Suite a
Statesboro, GA 30458
Phone
(912) 623-2391
Fax
(912) 623-2396
NPI assigned
Dec 2, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 076411 GA Primary

Addresses

Primary practice location

16741 Hwy 67
Suite a
Statesboro, GA 30458

Mailing address

16741 Hwy 67
Suite a
Statesboro, GA 30458
Phone (912) 623-2391

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20160818002209 GA Practitioner - Family Practice 5890003578 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Mercer University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
SJC Medical Group IncGroup PAC ID 7719978105, 57 clinicians

Practice addresses (Care Compare)

16741 Hwy 67
Suite a
Statesboro, GA 30458-2529
Phone (912) 623-2391

Hospital & facility affiliations

  • Centerwell Home Health Home health agency, Statesboro, GA, CCN 117033
  • Enhabit Home Health Home health agency, Hartwell, GA, CCN 117069
  • St Joseph'S Hospital - Savannah Hospital, Savannah, GA, CCN 110043
  • East Georgia Regional Medical Center Hospital, Statesboro, GA, CCN 110075
  • Candler Hospital Hospital, Savannah, GA, CCN 110024
  • Savannah Health Services LLC Dba Memorial Health University Medical Center Hospital, Savannah, GA, CCN 110036

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35644SCMDPharmacist
076411GAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SJC Medical Group Inc Family Medicine CurrentSince Jul 1, 2020 Accepting new patients
The Hospital Authority of Habersham County CurrentSince Aug 1, 2016 Accepting new patients
The Hospital Authority of Habersham County CurrentSince Aug 1, 2016 Accepting new patients

Locations

17 White St
Cleveland, GA 30528
Phone (706) 865-4001

541 441 Historic Hwy N
Demorest, GA 30535
Phone (706) 839-4000

11705 Mercy Blvd
Savannah, GA 31419
Phone (912) 819-2452

836 E 65th St
Ste 22
Savannah, GA 31405
Phone (912) 819-7878

16741 Highway 67
Ste A
Statesboro, GA 30458
Phone (912) 623-2391

Interoperability endpoints

  • Direct secure messaging: drpittman@direct.sjchs.org
  • Direct secure messaging: leslie.pittman@sjcmg.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.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1259712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645056000000",
    "number": "1013245091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16741 HWY 67",
            "address_2": "SUITE A",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "30458",
            "telephone_number": "912-623-2391",
            "fax_number": "912-623-2396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16741 HWY 67",
            "address_2": "SUITE A",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "30458",
            "telephone_number": "912-623-2391",
            "fax_number": "912-623-2396"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PITTMAN",
        "first_name": "LESLIE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-02",
        "last_updated": "2022-02-17",
        "certification_date": "2022-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "076411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Statesboro, GA

Sources for this page

Verify at the official NPI Registry.