NPIMap

Organization Active NPI

Jonathan I Macy M D Inc

  • Ophthalmology Physician
  • Los Angeles, CA
National Provider Identifier
1386745669
Registry record updated Aug 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
G35551 Issued in CA
Legal business name
JONATHAN I MACY M D INC
Practice address
8635 W 3Rd St Ste 360W
Los Angeles, CA 90048-6149
Phone
(310) 657-2777
Fax
(310) 657-0356
NPI assigned
Sep 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 1, 2022

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

Authorized official

Name
Jonathan Isaac Macy, M.D.NPI 1922020205
Title
President
Phone
(310) 657-2777

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X G35551 CA Primary

Addresses

Primary practice location

8635 W 3Rd St Ste 360W
Los Angeles, CA 90048-6149

Mailing address

8635 W 3Rd St Ste 360W
Los Angeles, CA 90048-6149
Phone (310) 657-2777

Other identifiers 1

IdentifierTypeStateIssuer
GR0086730MedicaidCA

Other names 1

  • Macy Eye Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031125000321 CA Part B Supplier - Clinic/Group Practice 9133023724 Receives reassigned benefits from 8 practitioners
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory
Tax ID family
Jonathan I Macy MD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Networks

  • BSC 65 PLUS INDIVIDUAL MAPDPlans: Blue Shield 65 Plus (HMO) (H0504-015-000, H0504); Blue Shield 65 Plus (HMO) (H0504-039-000, H0504); Blue Shield 65 Plus Plan 2 (HMO) (H0504-021-000, H0504); Blue Shield Inspire (HMO) (H0504-041-000, H0504); Blue Shield 65 Plus (HMO) (H0504-038-000, H0504); Blue Shield Inspire (HMO) (H0504-047-000, H0504); Blue Shield 65 Plus (HMO) (H0504-026-000, H0504); Blue Shield Advantage (HMO) (H0504-050-000, H0504); Blue Shield AdvantageOptimum Plan (HMO) (H5928-004-000, H5928); Blue Shield Inspire (HMO) (H0504-043-000, H0504)…

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659312000000",
    "number": "1386745669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8635 W 3RD ST STE 360W",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900486149",
            "telephone_number": "310-657-2777",
            "fax_number": "310-657-0356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8635 W 3RD ST STE 360W",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900486149",
            "telephone_number": "310-657-2777",
            "fax_number": "310-657-0356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JONATHAN I MACY M D INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2022-08-01",
        "certification_date": "2022-08-01",
        "status": "A",
        "authorized_official_last_name": "MACY",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "ISAAC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-657-2777",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CA",
            "license": "G35551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0086730",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Macy Eye Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Macy Eye Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.