Individual provider Active NPI

Marisa Ruth Leighton, NP

  • Family Nurse Practitioner
  • Paw Paw, MI
National Provider Identifier
1437404746
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
4704209420 Issued in MI
Practice address
451 Health Pkwy
Suite a
Paw Paw, MI 49079-8242
Phone
(269) 657-2550
Fax
(269) 657-2285
NPI assigned
Jul 24, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704209420 MI Primary

Addresses

Primary practice location

451 Health Pkwy
Suite a
Paw Paw, MI 49079-8242

Mailing address

451 Health Pkwy
Suite a
Paw Paw, MI 49079-8242
Phone (269) 657-2550

Other identifiers 2

IdentifierTypeStateIssuer
1801818752OtherMIBCBSM - BLH
1437404746MedicaidMI

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address direct@direct.bronsonhg.org Direct

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120918000538 MI Practitioner - Nurse Practitioner 3678721529 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Powerback Rehabilitation LLCGroup PAC ID 2365359932, shared by 106 NPIs, 600 clinicians
Bronson Lakeview HospitalGroup PAC ID 9032008495, 72 clinicians
Bronson Methodist HospitalGroup PAC ID 0244148633, 721 clinicians

Practice addresses (Care Compare)

3951 W Milham Ave
Portage, MI 49024-1088
Phone (269) 447-1689

451 Health Pkwy
Paw Paw, MI 49079-8242

451 Health Pkwy E
Bronson Lakeview Pediatrics
Paw Paw, MI 49079-8242
Phone (269) 655-3090

5623 Gull Rd
Suite 500
Kalamazoo, MI 49048-1097
Phone (269) 775-8031

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704209420MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bronson Lakeview Hospital CurrentSince Sep 1, 2012 Accepting new patients
Bronson Lakeview Hospital CurrentSince Sep 1, 2012 Accepting new patients
Bronson Methodist Hospital Family CurrentSince Jan 1, 2025 Accepting new patients

Locations

300 North Ave
Fl 2
Battle Creek, MI 49017
Phone (269) 245-5862

601 John St
Kalamazoo, MI 49007
Phone (269) 341-7100

601 John St
Ste M-124
Kalamazoo, MI 49007
Phone (269) 341-7500

6220 W Main St
Kalamazoo, MI 49009
Phone (269) 276-4744

5629 Stadium Dr
Ste B
Kalamazoo, MI 49009
Phone (269) 544-3270

601 John St
#2
Kalamazoo, MI 49007

5623 Gull Rd
Ste 500
Kalamazoo, MI 49048
Phone (269) 775-8031

52375 N Main St
Mattawan, MI 49071
Phone (269) 668-3348

451 Health Pkwy
Ste A
Paw Paw, MI 49079
Phone (269) 655-3065

451 Health Pkwy
Paw Paw, MI 49079
Phone (269) 655-1725

Interoperability endpoints

  • Direct secure messaging: mleighton12822@direct.bronsonhg.org
  • Direct secure messaging: direct@direct.bronsonhg.org

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 and National Provider Directory roles.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1343088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1437404746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "451 HEALTH PKWY",
            "address_2": "SUITE A",
            "city": "PAW PAW",
            "state": "MI",
            "postal_code": "490798242",
            "telephone_number": "269-657-2550",
            "fax_number": "269-657-2285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 HEALTH PKWY",
            "address_2": "SUITE A",
            "city": "PAW PAW",
            "state": "MI",
            "postal_code": "490798242",
            "telephone_number": "269-657-2550",
            "fax_number": "269-657-2285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEIGHTON",
        "first_name": "MARISA",
        "middle_name": "RUTH",
        "name_prefix": "Mrs.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-24",
        "last_updated": "2023-11-27",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704209420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM - BLH",
            "identifier": "1801818752",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1437404746",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "direct@direct.bronsonhg.org",
            "affiliation": "Y",
            "endpointDescription": "Bronson Healthcare Group Direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Continuity of Care Document",
            "address_1": "601 John St",
            "city": "Kalamazoo",
            "state": "MI",
            "country_code": "US",
            "postal_code": "490075341",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Paw Paw, MI

Sources for this page

Verify at the official NPI Registry.