Individual provider Active NPI

Leo G Frangipane Jr., MD

  • Surgery Physician
  • East Ellijay, GA
National Provider Identifier
1073624912
Registry record updated Mar 31, 2009
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(1) exclusion effective Apr 20, 2021.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
053812 Issued in GA
Practice address
765 Maddox Dr
Suite 2
East Ellijay, GA 30540-8189
Phone
(706) 515-1090
Fax
(706) 515-1093
NPI assigned
Aug 31, 2006
Last updated
Mar 31, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 053812 GA Primary

Addresses

Primary practice location

765 Maddox Dr
Suite 2
East Ellijay, GA 30540-8189

Mailing address

PO Box 488
East Ellijay, GA 30539-0009
Phone (706) 515-1090

Other identifiers 1

IdentifierTypeStateIssuer
196171338AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Dwic of Tampa Bay, Inc Past Accepting new patients
Northside Cherokee Urgent Care, LLC Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1238457600000",
    "number": "1073624912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 488",
            "city": "EAST ELLIJAY",
            "state": "GA",
            "postal_code": "305390009",
            "telephone_number": "706-515-1090",
            "fax_number": "706-515-1093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 MADDOX DR",
            "address_2": "SUITE 2",
            "city": "EAST ELLIJAY",
            "state": "GA",
            "postal_code": "305408189",
            "telephone_number": "706-515-1090",
            "fax_number": "706-515-1093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRANGIPANE",
        "first_name": "LEO",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2009-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "053812",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "196171338A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Ellijay, GA

Sources for this page

Verify at the official NPI Registry.