Organization Active NPI

Edward G Mackay, MD and Associates, LLC

  • Vascular Surgery Physician
  • Palm Harbor, FL
National Provider Identifier
1043774003
Registry record updated Jan 24, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
EDWARD G MACKAY, MD AND ASSOCIATES, LLC
Practice address
2863 Alternate 19 North
Palm Harbor, FL 34683
Phone
(727) 781-5652
Fax
(727) 781-3792
NPI assigned
Jan 24, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2019

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

Authorized official

Name
Edward G Mackay, MDNPI 1770548505
Title
Partner
Phone
(727) 781-5652

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 202K00000X
Vascular Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

2863 Alternate 19 North
Palm Harbor, FL 34683

Mailing address

2863 Alternate 19 North
Palm Harbor, FL 34683
Phone (727) 781-5652

Other practice location 1

2051 W Bay Dr
Largo, FL 33770-1924
Phone (727) 581-8346

Other practice location 2

7601 Dr Martin Luther King Jr St N Ste C2
St Petersburg, FL 33702-5200
Phone (727) 527-2888

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190304001788 FL Part B Supplier - Clinic/Group Practice 5193064467 Receives reassigned benefits from 5 practitioners
Practice locations: Largo, FL; Palm Harbor, FL; St Petersburg, FL

National Provider Directory

National Provider Directory

Locations

2051 West Bay Dr
Ste 1
Largo, FL 33770

2863 Alt 19
Ste 1
Palm Harbor, FL 34683

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1548288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548288000000",
    "number": "1043774003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2863 ALTERNATE 19 NORTH",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "34683",
            "telephone_number": "727-781-5652",
            "fax_number": "727-781-3792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2863 ALTERNATE 19 NORTH",
            "city": "PALM HARBOR",
            "state": "FL",
            "postal_code": "34683",
            "telephone_number": "727-781-5652",
            "fax_number": "727-781-3792"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2051 W Bay Dr",
            "address_purpose": "LOCATION",
            "city": "Largo",
            "state": "FL",
            "postal_code": "337701924",
            "country_code": "US",
            "telephone_number": "727-581-8346",
            "fax_number": "727-781-3792",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7601 Dr Martin Luther King Jr St N Ste C2",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337025200",
            "country_code": "US",
            "telephone_number": "727-527-2888",
            "fax_number": "727-781-3792",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EDWARD G MACKAY, MD AND ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-24",
        "last_updated": "2019-01-24",
        "status": "A",
        "authorized_official_last_name": "MACKAY",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "727-781-5652",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Phlebology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Harbor, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.