Leena Pravin Mane, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

61485 Issued in GA

Practice address

11 Dunwoody Park
Suite 150
Dunwoody, GA 30338-7408

Phone

(404) 778-6920

NPI assigned

Dec 28, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Leena Ajitrao More Other name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1198800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449532800000",
    "number": "1902081755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 DUNWOODY PARK",
            "address_2": "SUITE 150",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303387408",
            "telephone_number": "404-778-6920"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 DUNWOODY PARK",
            "address_2": "SUITE 150",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303387408",
            "telephone_number": "404-778-6920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANE",
        "first_name": "LEENA",
        "middle_name": "PRAVIN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-28",
        "last_updated": "2015-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "61485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEENA",
            "last_name": "MORE",
            "middle_name": "AJITRAO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Yaseen Makhzan, DMD
• Kathy Malcolm, LPC
• Lydia Mallari, CRNA
• Tamara Angelle Mallory
• Liya Tiru Mammo, PSYD
• Marcus Jewish Community Center of Atlanta, Inc.
• Chantay T Mardner, SPECIALIST
• Marin Matheus and Associates, LLC
• Marsha a Gordon DMD PC
• Kari Martinez, MS, RD

• Family Medicine Physician in Dunwoody, GA
• Providers in Dunwoody, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.