Troy Jonathan Lebaron, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004426 Issued in MI

Practice address

6750 Kalamazoo Ave SE
Grand Rapids, MI 49508-7897

Phone

(616) 656-0505

Fax

(616) 656-2750

NPI assigned

Aug 15, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

Locations

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

• Troy J. Lebaron OD PLLC

  • Optometrist
  • Kentwood, MI
  • NPI 1417700824
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1187136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712448000000",
    "number": "1124210091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6075 ADA DR SE",
            "city": "ADA",
            "state": "MI",
            "postal_code": "493017547",
            "telephone_number": "616-469-0056",
            "fax_number": "616-656-2750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6750 KALAMAZOO AVE SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495087897",
            "telephone_number": "616-656-0505",
            "fax_number": "616-656-2750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBARON",
        "first_name": "TROY",
        "middle_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-15",
        "last_updated": "2024-04-07",
        "certification_date": "2024-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Leary, MD
• Ann Marie Leasher, LMSW, CADC, SPADA
• Kelli Kay Leask, FNP-C
• Karen Hadley Leavitt, MD
• Calvin Leazenby, M.D
• Katherine M Lebarre, R.D
• Ansumana Lebbie
• Mitchell Lebel
• Patrick Joseph Leblanc, DPT
• Sagia Kii Leblanc

• Optometrist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2024; 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.