Individual provider Active NPI

Michael McKee, MD

  • Vascular Surgery Physician
  • Rockford, IL
National Provider Identifier
1306256185
Registry record updated Oct 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
036172434 Issued in IL
Practice address
444 Roxbury Rd
Rockford, IL 61107-5059
Phone
(815) 398-3000
Fax
(815) 391-5076
NPI assigned
May 2, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X A183442 CA
Vascular Surgery Physician 2086S0129X 23484 NV
Student in an Organized Health Care Education/Training Program 390200000X OH
Vascular Surgery Physician 2086S0129X 036172434 IL Primary

Addresses

Primary practice location

444 Roxbury Rd
Rockford, IL 61107-5059

Mailing address

444 Roxbury Rd
Rockford, IL 61107-5059
Phone (815) 398-3000

Other practice location 1

8930 W Sunset Rd Ste 300
Las Vegas, NV 89148-5013
Phone (702) 757-8877

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV, IL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230413000800 NV Practitioner - Vascular SurgeryPractitioner - General Surgery 7315253200 Reassigns benefits to 1 organization
I20241105003197 IL Practitioner - Vascular Surgery 7315253200

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Ohio State University College of Medicine, 2014
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

444 Roxbury Rd
Rockford, IL 61107-5059

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Leg revascularization (restoring blood flow)34

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A183442CAMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
LV Surgery Associates PLLC Vascular Surgery CurrentSince Mar 6, 2023 Accepting new patients

Locations

8930 W Sunset Rd
Ste 300
Las Vegas, NV 89148
Phone (702) 258-7788

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: michaeldavidmckee@wdsmdinc.allscriptsdirect.net

Organizations & group practices 1

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 1

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": "1398988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730160000000",
    "number": "1306256185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 ROXBURY RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075059",
            "telephone_number": "815-398-3000",
            "fax_number": "815-391-5076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 ROXBURY RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075059",
            "telephone_number": "815-398-3000",
            "fax_number": "815-391-5076"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8930 W Sunset Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891485013",
            "country_code": "US",
            "telephone_number": "702-757-8877",
            "fax_number": "702-757-8878",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKEE",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-02",
        "last_updated": "2024-10-29",
        "certification_date": "2024-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "CA",
            "license": "A183442",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NV",
            "license": "23484",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "IL",
            "license": "036172434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

Verify at the official NPI Registry.