Active NPI
Alfonso Generalao Llanto, MD
- Family Medicine Physician
- Watervliet, MI
National Provider Identifier
1154586451
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- AL038737
- Practice address
- 3973 M140
Watervliet, MI 49098 - Phone
- (269) 463-5711
- Fax
- (269) 463-2885
- NPI assigned
- Jul 25, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | AL038737 | MI | Primary |
Addresses
Primary practice location
3973 M140
Watervliet, MI 49098
Mailing address
Pob 127
Watervliet, MI 49098
Phone (269) 463-5711
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2093395 | Medicaid | MI | |
| 1101156072 | Other | MI | BCBS PIN # |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| AL038737 | MI | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216944000000",
"number": "1154586451",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "POB 127",
"city": "WATERVLIET",
"state": "MI",
"postal_code": "49098",
"telephone_number": "269-463-5711",
"fax_number": "269-463-2885"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3973 M140",
"city": "WATERVLIET",
"state": "MI",
"postal_code": "49098",
"telephone_number": "269-463-5711",
"fax_number": "269-463-2885"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LLANTO",
"first_name": "ALFONSO",
"middle_name": "GENERALAO",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-25",
"last_updated": "2008-07-25",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "AL038737",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2093395",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PIN #",
"identifier": "1101156072",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Watervliet, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.