Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Rena Mammoo

Individual provider Nurse Practitioner · NPI 1619352168

Rena Mammoo is a Nurse Practitioner in Chagrin Falls, Ohio. Qualified in 2014, 12 years ago. Practices with Minuteclinic Diagnostic of Ohio LLC, a 191-clinician group and accepts Medicare assignment. Licensed in Illinois and Ohio.

Years since qualifying
12
Licensed in
IL, OH
In the registry since
2015
Specialties on file
2

Practice location Address checks out

16801 Chillicothe Rd
Chagrin Falls, OH 44023-4618
Phone: (866) 389-2727
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 0030086 (OH)
Nurse Practitioner Taxonomy 363L00000X · Licence 209013051 (IL)

Record details

NPI number1619352168
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 27, 2015
Last updated in NPPESNovember 8, 2023
Certification dateNovember 8, 2023
Mailing address16801 Chillicothe Rd, Chagrin Falls, OH 44023-4618

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Minuteclinic Diagnostic Of Ohio Llc — 191 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Chagrin Falls