Luke Macyszyn MD Inc

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

Legal business name

LUKE MACYSZYN MD INC

Practice address

4551 Glencoe Ave Ste 145
Marina del Rey, CA 90292-6385

Phone

(424) 835-3100

NPI assigned

Oct 27, 2022

Organization subpart

No

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

Authorized official

Name

Luke Macyszyn, MDNPI 1225291842

Title

Owner

Phone

(424) 835-3100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, NV2 enrollments

Enrollment records 2

Locations

Practitioners 2

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

• Luke Macyszyn, MD, MA

  • Neurological Surgery Physician
  • Marina del Rey, CA
  • NPI 1225291842

  NV

  Medicare reassignment Care Compare group NPD Authorized official
• Alexis Rae Bolton

  • Family Nurse Practitioner
  • Downey, CA
  • NPI 1215546197
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1666828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710288000000",
    "number": "1104543354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3129",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905103129",
            "telephone_number": "310-792-3914",
            "fax_number": "855-898-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4551 GLENCOE AVE STE 145",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902926385",
            "telephone_number": "424-835-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUKE MACYSZYN MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-27",
        "last_updated": "2024-03-13",
        "certification_date": "2024-03-13",
        "status": "A",
        "authorized_official_last_name": "MACYSZYN",
        "authorized_official_first_name": "LUKE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "424-835-3100",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Candice Louise, LCSW
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• Luis E Torres M D Inc
• Luis H. Macias MD Inc
• Luxury Skin Care Med Spa Inc
• Anna Lyapina, FNP
• Hsien Ma, LIC.AC.
• Stacy Ma, MD
• Hang Thi Mac, PHARMD

• Neurological Surgery Physician in Marina del Rey, CA
• Providers in Marina del Rey, CA by specialty
• Neurological Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2024; 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.