Individual provider Active NPI

Marc Duane Christensen, MD, PHD, PA

  • Neurological Surgery Physician
  • Lake Havasu City, AZ
National Provider Identifier
1396747218
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
73109 Issued in AZ
Practice address
72 Lake Havasu Ave S Ste 102
Lake Havasu City, AZ 86403-0857
Phone
(928) 453-2211
Fax
(928) 453-2213
NPI assigned
Aug 11, 2005
Last updated
Dec 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 284220 MA
Neurological Surgery Physician 207T00000X 73109 AZ Primary

Addresses

Primary practice location

72 Lake Havasu Ave S Ste 102
Lake Havasu City, AZ 86403-0857

Mailing address

72 Lake Havasu Ave S Ste 102
Lake Havasu City, AZ 86403-0857
Phone (928) 453-2211

Other practice location 1

60 Fenwood Rd
Boston, MA 02115-6128
Phone (207) 240-0645

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, AZ2 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
I20211026000990 MA Practitioner - Neurosurgery 1850330069 Reassigns benefits to 1 organization
I20260227000830 AZ Practitioner - Neurosurgery 1850330069 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
University of Texas Medical School at Houston, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Panacea Brain and Spine LLCGroup PAC ID 0648423525, 2 clinicians

Practice addresses (Care Compare)

72 Lake Havasu Ave S
Suite 102
Lake Havasu City, AZ 86403-0857
Phone (928) 453-2211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine, Physician Assistant, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
73109AZMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham & Womens Physicians Organization Inc Neurological Surgery CurrentSince Jul 26, 2021 Accepting new patients
Panacea Brain and Spine, LLC Neurological Surgery CurrentSince Feb 1, 2026 Accepting new patients
Vna Care Network, Inc. Past Accepting new patients

Locations

72 Lake Havasu Ave S
Ste 102
Lk Havasu Cty, AZ 86403
Phone (928) 453-2211

1200 W Mohave Rd
Parker, AZ 85344
Phone (928) 669-7300

60 Fenwood Rd
Boston, MA 02115
Phone (617) 732-5056

75 Francis St
Boston, MA 02115

254 2nd Ave
Needham Heights, MA 02494
Phone (781) 416-8414

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1396747218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 LAKE HAVASU AVE S STE 102",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864030857",
            "telephone_number": "928-453-2211",
            "fax_number": "928-453-2213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 LAKE HAVASU AVE S STE 102",
            "city": "LAKE HAVASU CITY",
            "state": "AZ",
            "postal_code": "864030857",
            "telephone_number": "928-453-2211",
            "fax_number": "928-453-2213"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "60 Fenwood Rd",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021156128",
            "country_code": "US",
            "telephone_number": "207-240-0645",
            "fax_number": "617-713-3050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHRISTENSEN",
        "first_name": "MARC",
        "middle_name": "DUANE",
        "name_prefix": "Dr.",
        "credential": "MD, PHD, PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MA",
            "license": "284220",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "AZ",
            "license": "73109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Havasu City, AZ

Sources for this page

Verify at the official NPI Registry.