Individual provider Active NPI

Leslie Maness Harris, M.D.

  • Pediatrics Physician
  • Chicago, IL
National Provider Identifier
1023464930
Registry record updated Jun 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036164036 Issued in IL
Practice address
1725 W Harrison St Ste 710
Chicago, IL 60612-3863
Phone
(312) 942-3034
NPI assigned
May 10, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 63978 CT
Pediatrics Physician 208000000X 036164036 IL Primary

Addresses

Primary practice location

1725 W Harrison St Ste 710
Chicago, IL 60612-3863

Mailing address

1725 W Harrison St Ste 710
Chicago, IL 60612-3863
Phone (312) 942-3034

Other practice location 1

789 Howard Ave
Pediatrics Yale-New Haven Hospital
New Haven, CT 06519-1304
Phone (203) 688-5555

Other names 1

  • Leslie Diane Maness Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190827001273 CT Practitioner - Pediatric Medicine 1254625809 Reassigns benefits to 1 organization
I20230821001206 IL Practitioner - Pediatric Medicine 1254625809 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036164036ILMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Yale University Pediatrics CurrentSince Jul 18, 2019 Accepting new patients
Yale University CurrentSince Jul 18, 2019 Accepting new patients
Rush University Medical Group Pediatrics CurrentSince Aug 1, 2023 Accepting new patients

Locations

800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140

300 George St
Fl 6
New Haven, CT 06511
Phone (203) 785-6610

789 Howard Ave
North Haven, CT 06519
Phone (203) 688-2471

1700 W Van Buren St
#500
Chicago, IL 60612
Phone (312) 563-2875

1725 W Harrison St
Ste 710
Chicago, IL 60612
Phone (312) 942-5983

75 Remittance Dr
Dept 1611
Chicago, IL 60675

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": "1462838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1023464930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST STE 710",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123863",
            "telephone_number": "312-942-3034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 W HARRISON ST STE 710",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123863",
            "telephone_number": "312-942-3034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "789 Howard Ave",
            "address_2": "Pediatrics Yale-New Haven Hospital",
            "address_purpose": "LOCATION",
            "city": "New Haven",
            "state": "CT",
            "postal_code": "065191304",
            "country_code": "US",
            "telephone_number": "203-688-5555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "LESLIE",
        "middle_name": "MANESS",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-05-10",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "63978",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036164036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESLIE",
            "last_name": "MANESS",
            "middle_name": "DIANE",
            "credential": "M.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.