Individual provider Active NPI

Leopold M Fregoli, MD

  • Diagnostic Radiology Physician
  • Port Huron, MI
National Provider Identifier
1942212709
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
063336 Issued in MI
Practice address
1530 Pine Grove Ave
Ste 7
Port Huron, MI 48060
Phone
(810) 985-0029
Fax
(810) 985-0032
NPI assigned
Aug 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 063336 MI Primary

Addresses

Primary practice location

1530 Pine Grove Ave
Ste 7
Port Huron, MI 48060

Mailing address

1530 Pine Grove Ave
Ste 7
Port Huron, MI 48060
Phone (810) 985-0029

Other identifiers 1

IdentifierTypeStateIssuer
4094800MedicaidMI

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050617000947 MI Practitioner - Diagnostic Radiology 3678517869 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Wayne State University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McLaren Hospital GroupGroup PAC ID 2365968351, 366 clinicians
X-Ray Associates of Port Huron P CGroup PAC ID 5395789531, 28 clinicians

Practice addresses (Care Compare)

1163 S Carney Dr
Saint Clair, MI 48079-5569
Phone (810) 561-8450

120 N Delaware St
Sandusky, MI 48471-1009
Phone (810) 648-3770

1221 Pine Grove Ave
Port Huron, MI 48060-3511
Phone (810) 987-5000

1231 Pine Grove Ave
Port Huron, MI 48060-3500

1900 Columbus Ave
Bay City, MI 48708-6831
Phone (989) 894-3000

401 S Ballenger Hwy
Flint, MI 48532-3638
Phone (810) 342-2000

4100 S River Rd
East China, MI 48054-2909
Phone (810) 329-7111

7470 Brockway Rd
Brockway, MI 48097-3458
Phone (989) 516-5073

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.22 of 100Reported as group
Quality
95.56
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
063336MIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McLaren Hospital Group Diagnostic Radiology CurrentSince Dec 9, 2025 Accepting new patients
McLaren Flint CurrentSince Dec 9, 2025 Accepting new patients
Marwan Shuayto MD PC Diagnostic Radiology CurrentSince Dec 8, 2018 Accepting new patients
X-Ray Associates of Port Huron P C Diagnostic Radiology CurrentSince Jun 28, 1999 Accepting new patients
McLaren Central Michigan CurrentSince Dec 9, 2025 Accepting new patients
McLaren Flint Diagnostic Radiology CurrentSince Dec 9, 2025 Accepting new patients
McLaren Bay Region CurrentSince Dec 9, 2025 Accepting new patients
McLaren Central Michigan CurrentSince Dec 9, 2025 Accepting new patients
McLaren Bay Region CurrentSince Dec 9, 2025 Accepting new patients

Locations

4 Columbus Ave
Ste 160
Bay City, MI 48708
Phone (989) 377-4477

1900 Columbus Ave
Bay City, MI 48708
Phone (989) 894-3000

10090 E Lippincott Blvd
Davison, MI 48423
Phone (810) 653-1130

401 S Ballenger Hwy
Flint, MI 48532
Phone (810) 342-1000

1320 E M 32
Gaylord, MI 49735
Phone (231) 487-5400

1221 South Dr
Mt Pleasant, MI 48858
Phone (989) 772-6700

2940 Health Pkwy
Mt Pleasant, MI 48858
Phone (989) 466-2877

560 W Mitchell St
Ste 560
Petoskey, MI 49770
Phone (231) 487-2150

50 N Perry St
Pontiac, MI 48342
Phone (248) 338-5300

1530 Pine Grove Ave
Ste 7
Port Huron, MI 48060
Phone (810) 966-2273

1221 Pine Grove Ave
Port Huron, MI 48060
Phone (810) 989-3300

615 Pine St
Port Huron, MI 48060
Phone (810) 387-2318

1201 Stone St
Ste 8
Port Huron, MI 48060
Phone (810) 985-4411

Interoperability endpoints

  • Direct secure messaging: lfregoli1127243@direct.hfhs.org

Organizations & group practices 10

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 6

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": "1155340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942212709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1530 PINE GROVE AVE",
            "address_2": "STE 7",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "48060",
            "telephone_number": "810-985-0029",
            "fax_number": "810-985-0032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 PINE GROVE AVE",
            "address_2": "STE 7",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "48060",
            "telephone_number": "810-985-0029",
            "fax_number": "810-985-0032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREGOLI",
        "first_name": "LEOPOLD",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "063336",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4094800",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

Verify at the official NPI Registry.