Individual provider Active NPI

James R Mackenzie, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Traverse City, MI
National Provider Identifier
1043260102
Registry record updated Sep 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
4301050154 Issued in MI
Practice address
3988 W Royal Dr
Traverse City, MI 49684-9200
Phone
(231) 935-0860
Fax
(231) 935-0930
NPI assigned
May 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 4301050154 MI Primary

Addresses

Primary practice location

3988 W Royal Dr
Traverse City, MI 49684-9200

Mailing address

3988 W Royal Dr
Traverse City, MI 49684-9200
Phone (231) 935-0860

Other identifiers 1

IdentifierTypeStateIssuer
4159010MedicaidMI

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
I20041208000607 MI Practitioner - Physical Medicine and RehabilitationPractitioner - Interventional Pain Management 0042209306 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and RehabilitationAlso: Interventional Pain Management
Education
Wayne State University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DBMJ Rehabilitation Services PLLCGroup PAC ID 5799774022, 4 clinicians

Practice addresses (Care Compare)

3988 W Royal Dr
Traverse City, MI 49684-9200
Phone (231) 935-0860

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Munson Medical Center CurrentSince Apr 1, 2015 Accepting new patients
Munson Medical Center Current Accepting new patients
DBMJ Rehabilitation Services PLLC Physical Medicine & Rehabilitation CurrentSince Jan 1, 2000 Accepting new patients
Munson Medical Center CurrentSince Apr 1, 2015 Accepting new patients

Locations

2513 Momentum Pl
Chicago, IL 60689
Phone (231) 935-8031

14700 Lake Shore Dr
Charlevoix, MI 49720
Phone (231) 547-3840

829 N Center Ave
Ste 260
Gaylord, MI 49735
Phone (989) 731-6405

1105 Sixth St
Traverse City, MI 49684
Phone (231) 922-9000

3988 W Royal Dr
Traverse City, MI 49684
Phone (231) 421-1599

1221 Sixth St
Ste 300
Traverse City, MI 49684
Phone (231) 392-0640

1400 Medical Campus Dr
Traverse City, MI 49684
Phone (231) 935-8000

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CCFFDD/Endpoint/CCFFDD
  • Direct secure messaging: james.mackenzie@pmaonm.eclinicaldirectplus.com

Organizations & group practices 4

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": "1147305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1043260102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3988 W ROYAL DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496849200",
            "telephone_number": "231-935-0860",
            "fax_number": "231-935-0930"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3988 W ROYAL DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496849200",
            "telephone_number": "231-935-0860",
            "fax_number": "231-935-0930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKENZIE",
        "first_name": "JAMES",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-11",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "4301050154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4159010",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

Verify at the official NPI Registry.