Christie Mackenzie, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

34419TLG Issued in CA

Practice address

1936 University Ave Ste 112
Berkeley, CA 94704-1003

Phone

(510) 488-6767

NPI assigned

Jun 21, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

State University of New York - State College Optometry, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Solano Eye Care an Optometric CorporationGroup PAC ID 9830299940, 3 clinicians

Tania Mantua and Matt H Siu OD a Professional CorporationGroup PAC ID 2860556768, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Solano Eye Care an Optometric Corporation

  • Optometrist
  • Fairfield, CA
  • NPI 1528276854
  Medicare reassignment Care Compare group NPD
• Tania Mantua & Matt H Siu OD a Professional Corporation

  • Optometrist
  • Novato, CA
  • NPI 1376762229
  Medicare reassignment Care Compare group NPD
• Rosalia Saavedra,OD a Professional Corporation

  • Optometrist
  • San Leandro, CA
  • NPI 1225495922
  Medicare reassignment
• San Leandro Optometry GRP

  • Optometrist
  • San Leandro, CA
  • NPI 1568689107
  NPD (past)

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

{
    "created_epoch": "1466467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1124478128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1936 UNIVERSITY AVE STE 112",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041003",
            "telephone_number": "510-488-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1936 UNIVERSITY AVE STE 112",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947041003",
            "telephone_number": "510-488-6767"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 Boston St",
            "address_2": "#106",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212244723",
            "country_code": "US",
            "telephone_number": "410-507-9688",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACKENZIE",
        "first_name": "CHRISTIE",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-21",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MD",
            "license": "TA2533",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "34419TLG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mychal Verdad Macias
• Peter Macias
• Mack Jacob, DDS
• Robert Thomas Mack, MD
• Robert DS Mackay, M.D.
• Erin Cafaro Mackenzie
• Onagh Wallace Mackenzie, MD
• Stephanie Mackey
• Jill Dougal Mackinnon, M.D.
• Julia Macmillan, LM, CPM

• Optometrist in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.