Olivia L Mac, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

A154938 Issued in CA

Practice address

36320 Inland Valley Dr. #101a
Wildomar, CA 92595-7512

Phone

(951) 698-3000

Fax

(951) 698-7700

NPI assigned

Apr 20, 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

Electronic endpoints 1

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

Specialty

General SurgeryAlso: Critical Care (Intensivists)

Education

Medical College of Wisconsin, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Inland Valley Trauma and Acute Care Surgery Apc IncGroup PAC ID 9830444751, 11 clinicians

Murrieta Valley Surgery Associates Medical Group Inc ApcGroup PAC ID 6002136926, 16 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Southwest Healthcare Rancho Springs Hospital Hospital, Murrieta, CA, CCN 050701
• Temecula Valley Hospital Hospital, Temecula, CA, CCN 050775

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: omac136804@direct.llu.edu
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Inland Valley Trauma and Acute Care Surgery Apc Inc

  • Surgery Physician
  • Wildomar, CA
  • NPI 1417448168
  Medicare reassignment Care Compare group NPD
• Murrieta Valley Surgery Associates Medical Group, Inc, Apc

  dba Murrieta Valley Surgery Associates

  • Surgery Physician
  • Wildomar, CA
  • NPI 1760743454
  Medicare reassignment Care Compare group NPD
• Cal Med Physicians and Surgeons, Inc.

  • Surgery Physician
  • Colton, CA
  • NPI 1316054737

  Neurological Surgery

  Medicare reassignment NPD
• Physicians' Hospital of Murrieta, LLC

  dba Loma Linda University Medical Center-Murrieta

  • General Acute Care Hospital
  • Murrieta, CA
  • NPI 1386945947
  NPD (past)
• Temecula Valley Hospital Inc

  dba Temecula Valley Hospital

  • General Acute Care Hospital
  • Temecula, CA
  • NPI 1679816201
  NPD (past)
• Universal Health Services of Rancho Springs Inc

  dba Southwest Healthcare - Inland Valley Hospital

  • General Acute Care Hospital
  • Murrieta, CA
  • NPI 1245221050
  NPD (past)

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

• Temecula Valley Hospital Inc

  dba Temecula Valley Hospital

  • General Acute Care Hospital
  • Temecula, CA
  • NPI 1679816201
  Care Compare affiliation
• Universal Health Services of Rancho Springs Inc

  dba Southwest Healthcare - Inland Valley Hospital

  • General Acute Care Hospital
  • Murrieta, CA
  • NPI 1245221050
  Care Compare affiliation

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

{
    "created_epoch": "1461110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665964800000",
    "number": "1265886824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36320 INLAND VALLEY DR.",
            "address_2": "SUITE 101A",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925957512",
            "telephone_number": "951-698-3000",
            "fax_number": "951-698-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36320 INLAND VALLEY DR. #101A",
            "city": "WILDOMAR",
            "state": "CA",
            "postal_code": "925957512",
            "telephone_number": "951-698-3000",
            "fax_number": "951-698-7700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9961 Sierra Ave",
            "address_purpose": "LOCATION",
            "city": "Fontana",
            "state": "CA",
            "postal_code": "923356720",
            "country_code": "US",
            "telephone_number": "909-427-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAC",
        "first_name": "OLIVIA",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-20",
        "last_updated": "2022-10-17",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A154938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Desiree Luethy
• Lacy Luterman
• Cami Macdonlad
• Vanessa Machado
• Ameyalli Macias
• Diego Macias
• Sila Macias

• Surgery Physician in Wildomar, CA
• Providers in Wildomar, CA by specialty
• Surgery Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2022; 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.