Individual provider Active NPI

Marcelino Barreto, M.D.

  • Family Medicine Physician
  • Gladwin, MI
National Provider Identifier
1174548747
Registry record updated Sep 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MB062536 Issued in MI
Practice address
609 Quarter St
Gladwin, MI 48624-1941
Phone
(989) 246-6490
Fax
(989) 246-6495
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MB062536 MI Primary

Addresses

Primary practice location

609 Quarter St
Gladwin, MI 48624-1941

Mailing address

609 Quarter St
Gladwin, MI 48624-1941
Phone (989) 246-6371

Other identifiers 3

IdentifierTypeStateIssuer
3374238MedicaidMI
0802600042OtherMIBCBS -PIN
4251896MedicaidMA

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

LicenseStateTypeSpecialty
MB062536MIMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346976000000",
    "number": "1174548747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 QUARTER ST",
            "city": "GLADWIN",
            "state": "MI",
            "postal_code": "486241941",
            "telephone_number": "989-246-6371",
            "fax_number": "989-824-6633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "609 QUARTER ST",
            "city": "GLADWIN",
            "state": "MI",
            "postal_code": "486241941",
            "telephone_number": "989-246-6490",
            "fax_number": "989-246-6495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARRETO",
        "first_name": "MARCELINO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2012-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "MB062536",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3374238",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS -PIN",
            "identifier": "0802600042",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4251896",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gladwin, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.