NPIMap

Individual provider Active NPI

Leonard Alan Mankin, MD

  • Internal Medicine Physician
  • Portland, OR
National Provider Identifier
1710992201
Registry record updated Jul 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD25913 Issued in OR
Practice address
1200 NW 23Rd Ave
Portland, OR 97210-2906
Phone
(503) 494-8562
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2007

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 MD25913 OR Primary

Addresses

Primary practice location

1200 NW 23Rd Ave
Portland, OR 97210-2906

Mailing address

1112 Erickson St
Lake Oswego, OR 97034-4928
Phone (503) 938-9235

Other identifiers 1

IdentifierTypeStateIssuer
023217MedicaidOR

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050817000651 OR Practitioner - Internal Medicine 8123058328 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Geisel School of Medicine at Dartmouth, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Good Samaritan Hospital and Medical CenterGroup PAC ID 0547179939, 190 clinicians
Legacy Emanuel Hospital and Health CenterGroup PAC ID 4587573639, 235 clinicians

Practice addresses (Care Compare)

1200 NW 23Rd Ave
Portland, OR 97210-2906
Phone (503) 413-7074

2800 N Vancouver Ave
Suite 230
Portland, OR 97227-1668
Phone (503) 413-4340

Hospital & facility affiliations

  • Amedisys Home Health Care Home health agency, Portland, OR, CCN 387003
  • Assured Home Health Home health agency, Salem, OR, CCN 387093
  • Ohsu Hospital and Clinics Hospital, Portland, OR, CCN 380009
  • Legacy Good Samaritan Medical Center Hospital, Portland, OR, CCN 380017
  • Legacy Emanuel Medical Center Hospital, Portland, OR, CCN 380007
  • Legacy Meridian Park Medical Center Hospital, Tualatin, OR, CCN 380089

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD25913ORMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Emanuel Hospital & Health Center Current Accepting new patients
Legacy Clinics LLC Internal Medicine CurrentSince Aug 6, 2015 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center Current Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Feb 23, 2015 Accepting new patients
Legacy Emanuel Hospital & Health Center CurrentSince Feb 23, 2015 Accepting new patients
Legacy Good Samaritan Hospital and Medical Center Past Accepting new patients

Locations

1130 NW 22nd Ave
Ste 220
Portland, OR 97210
Phone (503) 413-4134

2800 N Vancouver Ave
Ste 201
Portland, OR 97227
Phone (503) 276-9000

1200 NW 23rd Ave
Portland, OR 97210
Phone (503) 413-7074

2800 N Vancouver Ave
Ste 230
Portland, OR 97227
Phone (503) 413-2901

2801 N Gantenbein Ave
Portland, OR 97227
Phone (503) 413-2200

Interoperability endpoints

  • Direct secure messaging: lmankin15734@direct.lhs.org

Organizations & group practices 6

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 10

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184803200000",
    "number": "1710992201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 ERICKSON ST",
            "city": "LAKE OSWEGO",
            "state": "OR",
            "postal_code": "970344928",
            "telephone_number": "503-938-9235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 NW 23RD AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972102906",
            "telephone_number": "503-494-8562"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANKIN",
        "first_name": "LEONARD",
        "middle_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD25913",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "023217",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.