Individual provider Active NPI

Marguerite Sango Lengue

  • Family Nurse Practitioner
  • Owings Mills, MD
National Provider Identifier
1114632346
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R199255 Issued in MD
Practice address
25 Crossroads Dr Ste 205
Owings Mills, MD 21117-5533
Phone
(410) 602-7792
Fax
(410) 602-9889
NPI assigned
Jan 23, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R199255 MD Primary

Addresses

Primary practice location

25 Crossroads Dr Ste 205
Owings Mills, MD 21117-5533

Mailing address

1589 Sulphur Spring Rd Ste 109
Baltimore, MD 21227-2542
Phone (443) 575-4880

Other names 1

  • Marguerite Mbouzou Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230425000033 MD Practitioner - Nurse Practitioner 8820453905 Reassigns benefits to 2 organizations
I20241129000110 DC Practitioner - Nurse Practitioner 8820453905 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Synergy Medical Group LLCGroup PAC ID 0749644177, 102 clinicians

Practice addresses (Care Compare)

1205 York Rd
Lutherville, MD 21093-6211
Phone (443) 325-0031

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Medical Group LLC CurrentSince Aug 19, 2024 Accepting new patients
Synergy Medical Group LLC CurrentSince Aug 19, 2024 Accepting new patients
Synergy Medical Group LLC CurrentSince Sep 20, 2024 Accepting new patients
Optimize Medical Group CurrentSince Jun 2, 2024 Accepting new patients
Synergy Medical Group LLC Current Accepting new patients
Post Acute Health Care Services LLC Past Accepting new patients

Locations

10 N Rock Glen Rd
Baltimore, MD 21229
Phone (410) 646-2100

4700 Harford Rd
Baltimore, MD 21214
Phone (410) 254-3300

1525 N Rolling Rd
Catonsville, MD 21228
Phone (410) 402-1200

3210 Powder Mill Rd
Hyattsville, MD 20783
Phone (301) 937-3939

1314 Bedford Ave
Ste 113
Pikesville, MD 21208
Phone (443) 868-7956

299 Hurley Ave
Rockville, MD 20850
Phone (301) 762-8900

1205 York Rd
Ste 11
Timonium, MD 21093
Phone (443) 325-0031

Interoperability endpoints

  • Direct secure messaging: marguerite.sango.lengue.1@25225.direct.athenahealth.com

Organizations & group practices 7

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": "1674432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1114632346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1589 SULPHUR SPRING RD STE 109",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212272542",
            "telephone_number": "443-575-4880",
            "fax_number": "443-575-4891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 CROSSROADS DR STE 205",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175533",
            "telephone_number": "410-602-7792",
            "fax_number": "410-602-9889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANGO LENGUE",
        "first_name": "MARGUERITE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-23",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R199255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARGUERITE",
            "last_name": "MBOUZOU",
            "credential": "CRNP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Owings Mills, MD

Sources for this page

Verify at the official NPI Registry.