Marcelo Granado Polanco, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

023828 Issued in LA

Practice address

731 S Main St Ste a
Church Point, LA 70525

Phone

(337) 684-0911

Fax

(337) 684-0912

NPI assigned

Oct 26, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

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

Specialty

Family Practice

Education

University of Texas Medical Branch at Galveston, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sunset Medical Clinic LLCGroup PAC ID 2062468994, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Landry Homecare Home health agency, Opelousas, LA, CCN 197136
• Opelousas General Health System Hospital, Opelousas, LA, CCN 190017

Procedures performed for Medicare patients

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.

• Sunset Medical Clinic LLC

  • Family Medicine Physician
  • Sunset, LA
  • NPI 1093702367
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• LHCG XV, LLC

  • Home Health Agency
  • Opelousas, LA
  • NPI 1538392238
  Care Compare affiliation
• Opelousas General Hospital Authority

  • General Acute Care Hospital
  • Opelousas, LA
  • NPI 1447230388
  Care Compare affiliation

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307404800000",
    "number": "1982789194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 S MAIN ST STE A",
            "city": "CHURCH POINT",
            "state": "LA",
            "postal_code": "70525",
            "telephone_number": "337-684-0911",
            "fax_number": "337-684-0912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 S MAIN ST STE A",
            "city": "CHURCH POINT",
            "state": "LA",
            "postal_code": "70525",
            "telephone_number": "337-684-0911",
            "fax_number": "337-684-0912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLANCO",
        "first_name": "MARCELO",
        "middle_name": "GRANADO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2011-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "023828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1485438",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pediatric Group of Acadiana LLC
• Pellman'S, LLC
• Sunethra Manel Perera Benoit
• Emily Ann Phillips, LAT, ATC
• Physical Therapy Services of Church Point Inc
• Rachel T Qaisieh, FNP
• McKenzi Richard
• Krystal Byers Rung, PHARM D.
• Jonea Savoie
• Sight Savers Transportation LLC

• Family Medicine Physician in Church Point, LA
• Providers in Church Point, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2011; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.