Active NPI
Michael Marceau, MD
- Psychiatry Physician
- Williamsport, PA
National Provider Identifier
1770545170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD041583E
- Practice address
- 1100 Grampian Blvd
Williamsport, PA 17701-1909 - Phone
- (570) 320-7525
- Fax
- (570) 320-7484
- NPI assigned
- Apr 3, 2006
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD041583E | PA | Primary |
Addresses
Primary practice location
1100 Grampian Blvd
Williamsport, PA 17701-1909
Mailing address
1201 Grampian Blvd
Williamsport, PA 17701-1900
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 224146 | Other | PA | VALUE OPTIONS |
| 807821 | Other | PA | FIRST PRIORITY HEALTH |
| 855218 | Other | PA | HIGHMARK BLUE SHIELD |
| 0015691220002 | Medicaid | PA |
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 |
|---|---|---|---|
| MD041583E | PA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144022400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456704000000",
"number": "1770545170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1201 GRAMPIAN BLVD",
"city": "WILLIAMSPORT",
"state": "PA",
"postal_code": "177011900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 GRAMPIAN BLVD",
"city": "WILLIAMSPORT",
"state": "PA",
"postal_code": "177011909",
"telephone_number": "570-320-7525",
"fax_number": "570-320-7484"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARCEAU",
"first_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-03",
"last_updated": "2016-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "PA",
"license": "MD041583E",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS",
"identifier": "224146",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST PRIORITY HEALTH",
"identifier": "807821",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "855218",
"state": "PA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0015691220002",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Williamsport, PA
- Jennifer Manning, DPT
- Kiersten Manno, M.S.
- Manor Care of Williamsport PA (North) LLC
- Manor Care of Williamsport PA (South) LLC
- Kathleen Victoria Marabella
- Marcus Riedhammer, MD, PC
- Lucas Charles Mariano, CRNP
- Dimitrius Peter Marinos, PA-C
- Mark Hampton Chiropractic Inc.
- Mark Hampton Chiropractic Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.