Active NPI
Chad Aaron Mackman, MD
- Pediatric Critical Care Medicine Physician
- Orlando, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Critical Care Medicine Physician
- License
- ME140887
- Practice address
- 601 E Rollins St
Orlando, FL 32803-1248 - Phone
- (407) 975-0410
- Fax
- (407) 975-0411
- NPI assigned
- Mar 24, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Cardiology Physician | 2080P0202X | R2913 | TX | |
| Pediatric Cardiology Physician | 2080P0202X | 56470-20 | WI | |
| Pediatric Critical Care Medicine Physician | 2080P0203X | 56470 | WI | |
| Pediatric Critical Care Medicine Physician | 2080P0203X | ME140887 | FL | Primary |
Addresses
Primary practice location
601 E Rollins St
Orlando, FL 32803-1248
Mailing address
1600 SW Archer Rd
Gainesville, FL 32610-3003
Phone (352) 627-9350
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 10535553966 | Medicaid | WI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TX, FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME140887 | FL | MD | Pediatric Critical Care Medicine Physician |
| 56470 | WI | MD | Pediatric Critical Care Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Hospital Medical Group Inc | Current | Accepting new patients | |
| Cook Children'S Physician Network | Current | Accepting new patients | |
| Cook Children'S Physician Network | Current | Accepting new patients | |
| Florida Clinical Practice Association Inc | Current | Accepting new patients | |
| Florida Hospital Medical Group Inc | Current | Accepting new patients | |
| Florida Clinical Practice Association Inc | Current | Accepting new patients |
Locations
2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990
1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077
2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700
601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996
801 7th Ave
Ft Worth, TX 76104
Phone (682) 885-4054
Interoperability endpoints
- cmackman127971@adventhealth.direct-ci.com
Organizations & group practices 6
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.
-
- Surgery Physician
- Gainesville, FL
- NPI 1063463768
-
- Family Medicine Physician
- Orlando, FL
- NPI 1225034234
-
- Pediatrics Physician
- Fort Worth, TX
- NPI 1750369203
-
- Durable Medical Equipment & Medical Supplies
- Ocala, FL
- NPI 1609529478
-
- Prosthetic/Orthotic Supplier
- Minneola, FL
- NPI 1285591545
-
- Pediatrics Physician
- Fort Worth, TX
- NPI 1083472062
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1237852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1634688000000",
"number": "1053553966",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 SW ARCHER RD",
"city": "GAINESVILLE",
"state": "FL",
"postal_code": "326103003",
"telephone_number": "352-627-9350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 E ROLLINS ST",
"city": "ORLANDO",
"state": "FL",
"postal_code": "328031248",
"telephone_number": "407-975-0410",
"fax_number": "407-975-0411"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACKMAN",
"first_name": "CHAD",
"middle_name": "AARON",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-03-24",
"last_updated": "2021-10-20",
"certification_date": "2021-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0202X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Cardiology",
"state": "TX",
"license": "R2913",
"primary": false
},
{
"code": "2080P0202X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Cardiology",
"state": "WI",
"license": "56470-20",
"primary": false
},
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "WI",
"license": "56470",
"primary": false
},
{
"code": "2080P0203X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Critical Care Medicine",
"state": "FL",
"license": "ME140887",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10535553966",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Orlando, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; 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.