Individual provider Active NPI

Ian Taylor Macqueen, M.D.

  • Surgery Physician
  • Santa Monica, CA
National Provider Identifier
1134486244
Registry record updated Oct 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A130834 Issued in CA
Practice address
1304 15TH St Ste 105
Santa Monica, CA 90404-1810
Phone
(310) 319-4080
Fax
(310) 394-5215
NPI assigned
Apr 13, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A130834 CA Primary

Addresses

Primary practice location

1304 15TH St Ste 105
Santa Monica, CA 90404-1810

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other practice location 1

200 Medical Plaza Suite 214
Los Angeles, CA 90095-1749
Phone (310) 794-7788

Medicare participation

Medicare enrollment files
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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141218000021 CA Practitioner - General Surgery 3476876715 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Southern California Keck School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
UCLA Associated General SurgeonsGroup PAC ID 6002728144, 46 clinicians

Practice addresses (Care Compare)

1260 15TH St
Suite 1200
Santa Monica, CA 90404-1147
Phone (310) 451-8751

757 Westwood PLZ
FL 7
Los Angeles, CA 90095-8358
Phone (310) 825-9111

Hospital & facility affiliations

  • Santa Monica - UCLA Med Ctr & Orthopaedic Hospital Hospital, Santa Monica, CA, CCN 050112
  • Ronald Reagan UCLA Medical Center Hospital, Los Angeles, CA, CCN 050262

Merit-based Incentive Payment System (MIPS)

Final score
92.77 of 100Reported as group
Quality
69.77
Promoting interoperability
100
Improvement activities
40
Cost
82.11

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)18
Hernia repair (minimally invasive)22
Upper gastrointestinal (GI) endoscopy for acid reflux14
Melanoma (skin cancer) excision1-10
Removal of tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A130834CAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
UCLA Associated General Surgeons Surgery CurrentSince Oct 7, 2019 Accepting new patients
UCLA Medical Group Surgery Past Accepting new patients
Regents Univ of Calif Los Angeles Past Accepting new patients
UCLA Associated General Surgeons Surgery Past Accepting new patients
The Regents of the University of California Past Accepting new patients

Locations

200 Medical Plz
Los Angeles, CA 90095
Phone (310) 206-6688

File 54206
Los Angeles, CA 90074

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

1260 15th St
Ste 1200
Santa Monica, CA 90404
Phone (310) 451-8751

1304 15th St
Ste 102
Santa Monica, CA 90404
Phone (310) 319-4080

Interoperability endpoints

  • Direct secure messaging: imacqueen43100@direct.uclahealth.org

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1334275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570752000000",
    "number": "1134486244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 15TH ST STE 105",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041810",
            "telephone_number": "310-319-4080",
            "fax_number": "310-394-5215"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Medical Plaza Suite 214",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900951749",
            "country_code": "US",
            "telephone_number": "310-794-7788",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACQUEEN",
        "first_name": "IAN",
        "middle_name": "TAYLOR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-13",
        "last_updated": "2019-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A130834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.