Mackenzie Macintyre III, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

843 Issued in NV

Practice address

670 N McCarran Blvd
Sparks, NV 89431-4600

Phone

(775) 358-1317

Fax

(775) 355-7522

NPI assigned

Oct 19, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

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

Pacific University - College of Optometry, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Demers Family Vision Group, Inc.Group PAC ID 2860594488, 5 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Demers Family Vision Group, Inc.

  • Optometrist
  • Sparks, NV
  • NPI 1649388794
  Medicare reassignment Care Compare group NPD
• Mt Grant General Hospital

  • Critical Access Hospital
  • Hawthorne, NV
  • NPI 1801844527
  NPD (past)
• Prime Healthcare Services - Reno LLC

  • General Acute Care Hospital
  • Reno, NV
  • NPI 1801152566
  NPD (past)
• Sparks Family Hospital Inc

  • General Acute Care Hospital
  • Sparks, NV
  • NPI 1548250582
  NPD (past)

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

{
    "created_epoch": "1318982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1326323478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 N MCCARRAN BLVD",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894314600",
            "telephone_number": "775-358-1317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 N MCCARRAN BLVD",
            "city": "SPARKS",
            "state": "NV",
            "postal_code": "894314600",
            "telephone_number": "775-358-1317",
            "fax_number": "775-355-7522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACINTYRE",
        "first_name": "MACKENZIE",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-19",
        "last_updated": "2022-07-21",
        "certification_date": "2022-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NV",
            "license": "843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaira Elaine Lyons, DNP, APRN, FNP-C
• Marilyn F Lyons, MPT
• Sherri S Lytle
• Michael M Macahito, RN
• Catherine Lee Macintosh, CADC INTERN
• Tatyanah Mackey
• Edward Mackie, RPH
• Mishaun Kathleen Maclellan, M.S. CCC SLP
• Brenda Madewell
• Steven Joel Madison, R.N.

• Optometrist in Sparks, NV
• Providers in Sparks, NV by specialty
• Optometrist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.