| Dr Leena Mammen, MD | |
|
3186 Village Dr Ste 201, Fayetteville, NC 28304-3979 | |
| (910) 486-5700 | |
| (910) 486-5950 |
| Full Name | Dr Leena Mammen |
|---|---|
| Gender | Female |
| Speciality | Diagnostic Radiology |
| Experience | 35 Years |
| Location | 3186 Village Dr Ste 201, Fayetteville, North Carolina |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275568826 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 4301081377 (Michigan) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | 2022-02626 (North Carolina) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Mclaren Greater Lansing | Lansing, MI | Hospital |
| Bronson Methodist Hospital | Kalamazoo, MI | Hospital |
| Spectrum Health | Grand rapids, MI | Hospital |
| Bronson Battle Creek Hospital | Battle creek, MI | Hospital |
| Munson Medical Center | Traverse city, MI | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mclaren Medical Group | 3971416082 | 314 |
| Advanced Radiology Services Pc | 4284546516 | 243 |
| Grand Traverse Radiologists Pc | 6002866407 | 29 |
| Advanced Radiology Services Pc | 4284546516 | 243 |
| Entity Name | Advanced Radiology Services Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1740283324 PECOS PAC ID: 4284546516 Enrollment ID: O20031104000494 |
| Entity Name | Grand Traverse Radiologists Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1760404891 PECOS PAC ID: 6002866407 Enrollment ID: O20050124000780 |
| Entity Name | Spartan Radiology Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1932768058 PECOS PAC ID: 5698003697 Enrollment ID: O20190829001596 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Leena Mammen, MD 3264 N Evergreen Dr Ne, Grand Rapids, MI 49525-9746 Ph: (616) 363-7272 | Dr Leena Mammen, MD 3186 Village Dr Ste 201, Fayetteville, NC 28304-3979 Ph: (910) 486-5700 |
Dr. Andrew Bostaph, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 3027 Hampton Ridge Rd, Fayetteville, NC 28311 Phone: 303-933-8270 Fax: 972-437-3369 | |
Sheryl Gillikin Jordan, M.D. Radiology Medicare: May Accept Medicare Assignments Practice Location: 1301 Medical Dr, Fayetteville, NC 28304 Phone: 910-486-5700 Fax: 910-486-5950 | |
James E. Shearer, M.D. Radiology Medicare: Medicare Enrolled Practice Location: 3186 Village Dr 201, Fayetteville, NC 28304 Phone: 910-486-5700 Fax: 910-486-5950 | |
Gretchen Elizabeth Green, M.D. Radiology Medicare: Medicare Enrolled Practice Location: 3186 Village Dr Ste 201, Fayetteville, NC 28304 Phone: 910-486-5700 Fax: 910-486-5950 | |
Irene Vasko, D.O. Radiology Medicare: Accepting Medicare Assignments Practice Location: 3186 Village Dr Ste 201, Fayetteville, NC 28304 Phone: 910-486-5700 Fax: 910-486-5950 | |
Leroy Roberts Jr., M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 3186 Village Dr 201, Fayetteville, NC 28304 Phone: 910-486-5700 | |
Ali Nasim, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 3186 Village Dr 201, Fayetteville, NC 28304 Phone: 910-486-5700 |