Leopoldo Maldonado, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

95759 Issued in GA

Practice address

2425 Brookstone Centre Pkwy
Columbus, GA 31904-4501

Phone

(706) 322-1700

NPI assigned

Jun 13, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Leopoldo Maldonado Gonzalez Former name

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Columbus Ambulatory Healthcare Services, Inc.

  • Family Medicine Physician
  • Columbus, GA
  • NPI 1790733244

  Pediatrics

  Medicare reassignment NPD
• Columbus Ambulatory Healthcare Services, Inc.

  • Family Medicine Physician
  • Phenix City, AL
  • NPI 1699240531
  NPD

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

{
    "created_epoch": "1497312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694563200000",
    "number": "1831629831",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1483",
            "city": "TRUJILLO ALTO",
            "state": "PR",
            "postal_code": "009771483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2425 BROOKSTONE CENTRE PKWY",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319044501",
            "telephone_number": "706-322-1700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Gobernador Pinero",
            "address_2": "San Juan City Hospital, Pediatric Department",
            "address_purpose": "LOCATION",
            "city": "San Juan",
            "state": "PR",
            "postal_code": "00936",
            "country_code": "US",
            "telephone_number": "787-480-2700 x5885",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "LEOPOLDO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-13",
        "last_updated": "2023-09-13",
        "certification_date": "2023-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "95759",
            "primary": true
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "GA",
            "license": "95759",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PR",
            "license": "21115",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEOPOLDO",
            "last_name": "MALDONADO GONZALEZ",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sasha Adaiah Mainer
• James Davant Majors, M.D.
• Eric Paul Malaney
• Jessica Maldonado
• Jonathan Maldonado, RBT
• Thomas William Maldonado
• Yaira Maldonado
• Denis Yevgenyevich Malkov, DO, MD
• Ivy J Mallisham, PSY.D.
• Jelicka M Mallory

• Pediatrics Physician in Columbus, GA
• Providers in Columbus, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.