Active NPI
Leo Maranon Madarang, MD
- Surgery Physician
- Flint, MI
National Provider Identifier
1285672691
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 35518
- Practice address
- 3200 Beecher Rd.
Ste 02
Flint, MI 48532-3685 - Phone
- (810) 342-5500
- NPI assigned
- Jun 4, 2006
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 35518 | MI | Primary |
Addresses
Primary practice location
3200 Beecher Rd.
Ste 02
Flint, MI 48532-3685
Mailing address
820 Boutell Dr
Grand Blanc, MI 48439-1943
Phone (810) 210-7072
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2097957 | Medicaid | MI | |
| 0250315 | Other | MI | BLUECARE NETWORK |
| 0250315 | Other | MI | BLUE CROSS BLUE SHIELD OF |
| 382817349 | Other | MI | EMPLOYER ID# |
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 |
|---|---|---|---|
| 35518 | MI | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1225843200000",
"number": "1285672691",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "820 BOUTELL DR",
"city": "GRAND BLANC",
"state": "MI",
"postal_code": "484391943",
"telephone_number": "810-210-7072"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3200 BEECHER RD.",
"address_2": "STE 02",
"city": "FLINT",
"state": "MI",
"postal_code": "485323685",
"telephone_number": "810-342-5500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADARANG",
"first_name": "LEO",
"middle_name": "MARANON",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-04",
"last_updated": "2008-11-05",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MI",
"license": "35518",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2097957",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECARE NETWORK",
"identifier": "0250315",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD OF",
"identifier": "0250315",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPLOYER ID#",
"identifier": "382817349",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Flint, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 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.