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DR. SHANTAE MANGAROO M.D.
NPI 1902293434
Family Medicine in Lithonia, GA

Active since April 22, 2015PECOS EnrolledAccepts Medicare Assignment
8011 MALL PKWY, LITHONIA, GA 30038(404) 518-8056 Get Directions Write a Review

NPPES record last updated: April 14, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 14, 2022, Jun 21, 2018 (2 updates tracked since 2018).

About Dr. Shantae Mangaroo M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SHANTAE MANGAROO M.D. (NPI 1902293434) is an individual family medicine provider in Lithonia, Georgia, licensed in Georgia (80684) and active in the NPI registry since April 2015. She is enrolled in Medicare PECOS and is a graduate of Morehouse School Of Medicine (2014).

NPPES Registry Identity

NPI1902293434
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameDR. SHANTAE MANGAROOCredential: M.D.
Location Address8011 MALL PKWYLithonia, GA 30038
Mailing Address8011 Mall PkwyLithonia, GA 30038-2543 · (404) 518-8056
Phone(404) 518-8056
Sole ProprietorYes
Medical School CMSMorehouse School Of MedicineGraduated 2014
Enumeration DateApril 22, 2015
Last NPPES UpdateApril 14, 20222 updates tracked since enumeration
NPPES CertifiedApril 14, 2022
✔ NPI 1902293434 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in GA · 80684
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
8011 MALL PKWY, Lithonia, GA 30038
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Shantae Mangaroo M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID9830491224
PECOS Enrollment IDI20181128001676
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30038 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.06 typical visit price
range $56.84 – $172.43
Typical copayment $22.01 (range $14.21 – $43.10)
Most-billed visit code 99203
Established Patient
$100.20 typical visit price
range $18.22 – $140.40
Typical copayment $25.05 (range $4.55 – $35.10)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KAISER FOUNDATION HEALTH PLAN OF GEORGIA INC.
Clinical Medical Laboratory
8011 MALL PKWY
LITHONIA, GA 30038
Dekalb County (678) 323-7512
JASMINE ADEGBUJI PHARMD
Pharmacist
8011 MALL PKWY
STONECREST, GA 30038
Dekalb County (678) 697-1764
KAISER FOUNDATION HEALTH PLAN OF GEORGIA, INC.
Pharmacy (Managed Care Organization Pharmacy)
8011 MALL PKWY
LITHONIA, GA 30038
Dekalb County (678) 323-7580

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shantae Mangaroo's NPI number?

The NPI number for Shantae Mangaroo is 1902293434. It was assigned to this individual provider in the NPPES registry on April 22, 2015.

Where is Shantae Mangaroo located?

Shantae Mangaroo practices at 8011 Mall Pkwy, Lithonia, GA 30038. The listed phone number is (404) 518-8056.

What is Shantae Mangaroo's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Shantae Mangaroo enrolled in Medicare?

Yes. Shantae Mangaroo is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Shantae Mangaroo was last updated on April 14, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.