Michael G Macon, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

53388 Issued in AZ

Practice address

7700 E Florentine Rd
BLDG B, Ste 203
Prescott Valley, AZ 86314-2245

Phone

(928) 442-8740

Fax

(928) 442-8142

NPI assigned

May 23, 2005

Last updated

Feb 21, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Maryland Surgeons PA

  • Specialist
  • Columbia, MD
  • NPI 1255347019
  NPD (past)

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487635200000",
    "number": "1174526222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10880",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863040880",
            "telephone_number": "928-759-5874",
            "fax_number": "928-458-2039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7700 E FLORENTINE RD",
            "address_2": "BLDG B, STE 203",
            "city": "PRESCOTT VALLEY",
            "state": "AZ",
            "postal_code": "863142245",
            "telephone_number": "928-442-8740",
            "fax_number": "928-442-8142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACON",
        "first_name": "MICHAEL",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-23",
        "last_updated": "2017-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "D0030763",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "53388",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126571700",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "218939",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yingqiao Luo
• Lisa Lynn Lusk
• M & M Eye Institute, PLC
• Machuzak Dermatology PLLC (JM Dermatology)
• Jennifer Macias
• Scott Madsen, P.T.
• Claudia Adriana Magda
• Patrick James Mahaney, MD
• Crystal Marie Makinson
• Harold Martin Maller, MD

• Surgery Physician in Prescott Valley, AZ
• Providers in Prescott Valley, AZ by specialty
• Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.