Susanne Blanchette Mackie-Lee, MD MPH

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

0101055325 Issued in VA

Practice address

7500 Iron Bar LN
Gainesville, VA 20155

Phone

(703) 753-6772

NPI assigned

Nov 2, 2005

Sex

Female

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 VA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: susannemackie@mpac.pcc-direct.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Emergency Medicine Associates, P.a.,P.C.

  • Internal Medicine Physician
  • Dulles, VA
  • NPI 1376917070
  Medicare reassignment NPD
• Milestones Pediatric and Adolescent Care, LLC

  • Pediatrics Physician
  • Gainesville, VA
  • NPI 1114352598
  NPD (past)
• Mid-Atlantic Critical Care Services,L.L.C.

  • Critical Care Medicine (Internal Medicine) Physician
  • Takoma Park, MD
  • NPI 1164455853
  NPD (past)

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566000000000",
    "number": "1073504759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 PICCARD DR",
            "address_2": "STE 202",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208504303",
            "telephone_number": "301-921-7900",
            "fax_number": "301-921-7915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7500 IRON BAR LN",
            "city": "GAINESVILLE",
            "state": "VA",
            "postal_code": "20155",
            "telephone_number": "703-753-6772"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8700 Sudley Rd",
            "address_2": "Prince William Hospital",
            "address_purpose": "LOCATION",
            "city": "Manassas",
            "state": "VA",
            "postal_code": "201104418",
            "country_code": "US",
            "telephone_number": "703-369-8337",
            "fax_number": "703-369-8868",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACKIE-LEE",
        "first_name": "SUSANNE",
        "middle_name": "BLANCHETTE",
        "credential": "MD MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-02",
        "last_updated": "2019-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "VA",
            "license": "0101055325",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "006731911",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kenneth Tri Luong, DC
• Ronald Franklin Luxenburg, O.D.
• Luxottica of America Inc. (Target Optical #2114)
• Luxottica of America Inc. (Lenscrafters at Macy's #3968)
• Samuel Lwanyaga, AGPCNP
• Karen Maclean
• Meghan Maddock, PHD
• Stephanie Maddox, M.S., BCBA
• Kurt Laurence Maggio, M.D.
• Kevin Maggs, D.C.

• Pediatrics Physician in Gainesville, VA
• Providers in Gainesville, VA by specialty
• Pediatrics Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2019; 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.

Verify at the official NPI Registry.