Active NPI
Gregory Lee Mangum, DPM
- Foot & Ankle Surgery Podiatrist
- Houston, TX
National Provider Identifier
1336239359
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- 0607
- Practice address
- 4868 Beechnut St
Houston, TX 77096 - Phone
- (713) 664-6677
- Fax
- (713) 664-7096
- NPI assigned
- Oct 13, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | 0607 | TX | Primary |
Addresses
Primary practice location
4868 Beechnut St
Houston, TX 77096
Mailing address
4868 Beechnut St
Houston, TX 77096
Phone (713) 664-6677
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0607 | Other | TX | LISCENCE |
| J0084884 | Other | TX | DPS |
| 121579003 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Podiatry
- Education
- Temple University School of Podiatric Medicine, 1977
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4868 Beechnut St
Houston, TX 77096-1604
Phone (713) 664-6677
6021 Fairmont Pkwy
Suite 130
Pasadena, TX 77505-4505
Phone (281) 991-0600
6021 Fairmont Pky
Suite 130
Pasedena, TX 77505-4505
Hospital & facility affiliations
- Memorial Hermann Hospital System
- Memorial Hermann Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 242 |
| Removal of skin lesions | 1-10 |
| Removal of nail tissue | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Texas Foot Specialist Inc | Foot & Ankle Surgery | Current | Accepting new patients |
| Associated Foot Specialist of Pearland | Foot & Ankle Surgery | Past | Accepting new patients |
Locations
4868 Beechnut St
Houston, TX 77096
Phone (713) 664-6677
6021 Fairmont Pkwy
Ste 130
Pasadena, TX 77505
Phone (281) 991-0600
3311 Broadway St
Pearland, TX 77581
Phone (281) 412-4950
Interoperability endpoints
- gmangum46851@memorialhermann.direct-ci.com
Organizations & group practices 2
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.
-
- Foot & Ankle Surgery Podiatrist
- Pasadena, TX
- NPI 1528131810
-
- Foot & Ankle Surgery Podiatrist
- Pearland, TX
- NPI 1164595369
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Rehabilitation Hospital Unit
- Houston, TX
- NPI 1669414884
Inpatient rehabilitation facility
-
- General Acute Care Hospital
- Houston, TX
- NPI 1730132234
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160697600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1336239359",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4868 BEECHNUT ST",
"city": "HOUSTON",
"state": "TX",
"postal_code": "77096",
"telephone_number": "713-664-6677",
"fax_number": "713-664-7096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4868 BEECHNUT ST",
"city": "HOUSTON",
"state": "TX",
"postal_code": "77096",
"telephone_number": "713-664-6677",
"fax_number": "713-664-7096"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANGUM",
"first_name": "GREGORY",
"middle_name": "LEE",
"name_prefix": "Mr.",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-13",
"last_updated": "2023-03-07",
"certification_date": "2019-12-20",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "TX",
"license": "0607",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LISCENCE",
"identifier": "0607",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DPS",
"identifier": "J0084884",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "121579003",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.