NPIMap

Individual provider Active NPI

Andrew Blaine Mackersie, M.D.

  • Diagnostic Radiology Physician
  • Lansing, MI
National Provider Identifier
1346207974
Registry record updated Feb 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
4301086690 Issued in MI
Practice address
1215 E Michigan Ave
Lansing, MI 48912-1811
Phone
(517) 351-4905
Fax
(517) 351-4820
NPI assigned
Apr 27, 2006
Last updated
Feb 15, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 01053750A IN
Diagnostic Radiology Physician 2085R0202X 4301086690 MI Primary

Addresses

Primary practice location

1215 E Michigan Ave
Lansing, MI 48912-1811

Mailing address

3264 N Evergreen Dr NE
Grand Rapids, MI 49525-9746
Phone (616) 363-7339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080711000577 MI Practitioner - Diagnostic Radiology 9436173267 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Wayne State University School of Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1215 E Michigan Ave
Unitversity of Michigan Health Spar
Lansing, MI 48912-1811
Phone (517) 364-5650

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01053750AINMDDiagnostic Radiology Physician
4301086690MIMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Edward W Sparrow Hospital Association CurrentSince Jul 1, 2024 Accepting new patients
Edward W Sparrow Hospital Association CurrentSince Jul 1, 2024 Accepting new patients
Lansing Radiology Associates P C Diagnostic Radiology CurrentSince Jun 30, 2008 Accepting new patients
The Union Hospital Association Past Accepting new patients

Locations

4748 Reliable Pkwy
Chicago, IL 60686

8175 Reliable Pkwy
Chicago, IL 60686

2035 Asher Ct
Ste 2081
East Lansing, MI 48823

3264 N Evergreen Dr NE
Grand Rapids, MI 49525
Phone (616) 391-6001

1200 E Michigan Ave
Fl 1
Lansing, MI 48912

1200 E Michigan Ave
Ste 500
Lansing, MI 48912
Phone (517) 364-5123

1215 E Michigan Ave
Lansing, MI 48912
Phone (517) 336-8080

1215 E Michigan Ave
Fl 4
Lansing, MI 48912
Phone (517) 364-3480

401 W Greenlawn Ave
Lansing, MI 48910
Phone (517) 334-2286

Organizations & group practices 4

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.

Hospital & facility affiliations 8

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": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1266192000000",
    "number": "1346207974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3264 N EVERGREEN DR NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259746",
            "telephone_number": "616-363-7339",
            "fax_number": "616-361-5828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 E MICHIGAN AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489121811",
            "telephone_number": "517-351-4905",
            "fax_number": "517-351-4820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKERSIE",
        "first_name": "ANDREW",
        "middle_name": "BLAINE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2010-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01053750A",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301086690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.