Individual provider Active NPI

Haldon M. Marmolejos, DO

  • Anesthesiology Physician
  • Keesler AFB, MS
National Provider Identifier
1740868876
Registry record updated Aug 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
02008215A Issued in IN
Practice address
301 Fisher St
Keesler AFB, MS 39534-2508
Phone
(228) 376-6030
NPI assigned
Mar 30, 2021
Last updated
Aug 26, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 02008215A IN Primary
Student in an Organized Health Care Education/Training Program 390200000X
Military Health Care Provider 171000000X 02008215A IN

Addresses

Primary practice location

301 Fisher St
Keesler AFB, MS 39534-2508

Mailing address

301 Fisher St
Keesler AFB, MS 39534-2508
Phone (228) 376-6030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20260316000260 AL Practitioner - Anesthesiology 6002399300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

10 Woodbridge Ctr Dr
Suite 425
Woodbridge, NJ 07095-1170

PO Box
Montgomery, AL 36123

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
02008215AINMDMilitary Health Care Provider

Practice roles

OrganizationSpecialtyStatusNew patients
USA Health Anesthesia Billing Services, LLC Anesthesiology CurrentSince Mar 2, 2026 Accepting new patients

Locations

6801 Airport Blvd
Mobile, AL 36608
Phone (251) 266-3580

Organizations & group practices 1

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": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787702400000",
    "number": "1740868876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 FISHER ST",
            "city": "KEESLER AFB",
            "state": "MS",
            "postal_code": "395342508",
            "telephone_number": "228-376-6030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 FISHER ST",
            "city": "KEESLER AFB",
            "state": "MS",
            "postal_code": "395342508",
            "telephone_number": "228-376-6030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARMOLEJOS",
        "first_name": "HALDON",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-30",
        "last_updated": "2026-08-26",
        "certification_date": "2026-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IN",
            "license": "02008215A",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "IN",
            "license": "02008215A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Keesler AFB, MS

Sources for this page

Verify at the official NPI Registry.