Active NPI
Renan Macias, MD
- Neurology Physician
- Elmhurst, NY
National Provider Identifier
1407801475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 123163
- Practice address
- 9427 59TH Ave
Unit F6
Elmhurst, NY 11373-5150 - Phone
- (718) 592-0449
- Fax
- (718) 313-0442
- NPI assigned
- May 24, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 123163 | NY | Primary |
Addresses
Primary practice location
9427 59TH Ave
Unit F6
Elmhurst, NY 11373-5150
Mailing address
9427 59TH Ave
Unit F6
Elmhurst, NY 11373-5150
Phone (718) 592-0449
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00231503 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 123163 | NY | MD | Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148428800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1379635200000",
"number": "1407801475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9427 59TH AVE",
"address_2": "UNIT F6",
"city": "ELMHURST",
"state": "NY",
"postal_code": "113735150",
"telephone_number": "718-592-0449",
"fax_number": "718-313-0442"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9427 59TH AVE",
"address_2": "UNIT F6",
"city": "ELMHURST",
"state": "NY",
"postal_code": "113735150",
"telephone_number": "718-592-0449",
"fax_number": "718-313-0442"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACIAS",
"first_name": "RENAN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-05-24",
"last_updated": "2013-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "NY",
"license": "123163",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00231503",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elmhurst, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2013; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.