Individual provider Active NPI

Mederic W Leblanc, MD

  • General Practice Physician
  • Lancaster, NH
National Provider Identifier
1689751935
Registry record updated Apr 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
9964 Issued in NH
Practice address
173 Middle St
Lancaster, NH 03584-3508
Phone
(603) 788-4911
Fax
(603) 788-5027
NPI assigned
Nov 1, 2006
Last updated
Apr 9, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 9964 NH
General Practice Physician 208D00000X 9964 NH Primary

Addresses

Primary practice location

173 Middle St
Lancaster, NH 03584-3508

Mailing address

173 Middle St
Lancaster, NH 03584-3508
Phone (603) 788-4911

Other identifiers 2

IdentifierTypeStateIssuer
30010643MedicaidNH
ORE4522MedicaidVT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221223000730 AZ Practitioner - Family PracticePractitioner - Emergency Medicine 7810902913 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
9964NHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care of Arizona PA CurrentSince Jul 1, 2023 Accepting new patients
Coos County Family Health Services, Inc PastSince May 25, 2025 Accepting new patients

Locations

1110 E Route 66
Ste 100
Flagstaff, AZ 86001
Phone (928) 527-1920

7119 E Broadway Blvd
Tucson, AZ 85710
Phone (520) 881-0050

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712620800000",
    "number": "1689751935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "173 MIDDLE ST",
            "city": "LANCASTER",
            "state": "NH",
            "postal_code": "035843508",
            "telephone_number": "603-788-4911",
            "fax_number": "603-788-5027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 MIDDLE ST",
            "city": "LANCASTER",
            "state": "NH",
            "postal_code": "035843508",
            "telephone_number": "603-788-4911",
            "fax_number": "603-788-5027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEBLANC",
        "first_name": "MEDERIC",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2024-04-09",
        "certification_date": "2024-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NH",
            "license": "9964",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NH",
            "license": "9964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30010643",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ORE4522",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, NH

Sources for this page

Verify at the official NPI Registry.