John Dewolfe Mackenzie, MD

Primary specialty

Pediatric Radiology PhysicianTaxonomy code 2085P0229X

License

MD60942783 Issued in WA

Practice address

19020 33Rd Ave W Ste 210
Lynnwood, WA 98036

Phone

(425) 563-1500

Fax

(425) 563-1501

NPI assigned

Jun 27, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 7

Medicare fee-for-service enrollment

Enrolled in CA, WA, MI3 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 3

Specialty

Diagnostic Radiology

Education

Albert Einstein College of Medicine of Yeshiva University, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Yakima Valley Memorial PhysiciansGroup PAC ID 1557391596, 397 clinicians

Medford Radiological Group PCGroup PAC ID 2062303324, 91 clinicians

Tower Imaging Medical Associates IncGroup PAC ID 2163608688, 93 clinicians

Radia Oregon Radiology Medical Group LLCGroup PAC ID 2961852637, 122 clinicians

Central Washington Health Services AssociationGroup PAC ID 4880504596, 708 clinicians

Radia California Radiology Medical Group IncGroup PAC ID 8921465998, 134 clinicians

Radia Inc P SGroup PAC ID 9931012812, 275 clinicians

County of Santa ClaraGroup PAC ID 1254244973, shared by 46 NPIs, 1,000 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Yakima Valley Memorial Hospital, Yakima, WA, CCN 500036
• Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018
• Santa Clara Valley Medical Center Hospital, San Jose, CA, CCN 050038
• Providence Santa Rosa Memorial Hospital Hospital, Santa Rosa, CA, CCN 050174
• Peacehealth Southwest Medical Cente Hospital, Vancouver, WA, CCN 500050

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 47)

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/ef853cc1-94e4-4ed7-883a-9be7485e458e/

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.

• Central Washington Health Services Association

  dba Confluence Health

  • General Acute Care Hospital
  • Wenatchee, WA
  • NPI 1881642239

  CA

  Medicare reassignment Care Compare group NPD
• Radia Inc P S

  dba Radia

  • Diagnostic Radiology Physician
  • Lynnwood, WA
  • NPI 1932196607

  CA

  Medicare reassignment Care Compare group NPD
• Yakima Valley Memorial Physicians

  • General Acute Care Hospital
  • Yakima, WA
  • NPI 1306933940
  Medicare reassignment Care Compare group NPD
• Medford Radiological Group, PC

  • Diagnostic Radiology Physician
  • Medford, OR
  • NPI 1407938111

  CA

  Medicare reassignment Care Compare group NPD
• Radia California Radiology Medical Group Inc

  dba Radia California

  • Diagnostic Radiology Physician
  • Santa Rosa, CA
  • NPI 1740982032
  Medicare reassignment Care Compare group NPD
• Radia Oregon Radiology Medical Group LLC

  dba Radia Oregon

  • Diagnostic Radiology Physician
  • Medford, OR
  • NPI 1073385423

  CA

  Medicare reassignment Care Compare group NPD
• Tower Imaging Medical Associates, Inc.

  • Diagnostic Radiology Physician
  • Los Angeles, CA
  • NPI 1023315074
  Medicare reassignment Care Compare group NPD
• Evergreen Radia LLC

  dba Evergreen Radia

  • Diagnostic Radiology Physician
  • Kirkland, WA
  • NPI 1922095694

  CA

  Medicare reassignment NPD
• Radia Imaging Center Holdings LLC

  dba Seattle Radiology

  • Diagnostic Radiology Physician
  • Seattle, WA
  • NPI 1639653017

  CA

  Medicare reassignment NPD
• Swedish Health Services

  dba Swedish Imaging Clinics

  • Body Imaging Physician
  • Everett, WA
  • NPI 1114356904
  Medicare reassignment NPD
• Swedish Health Services

  • Internal Medicine Physician
  • Seattle, WA
  • NPI 1689612954
  Medicare reassignment NPD
• Swedish Radia Imaging Center at Edmonds LLC

  dba Swedish Radia Edmonds

  • Diagnostic Radiology Physician
  • Edmonds, WA
  • NPI 1164494373

  CA

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Peacehealth

  dba PeaceHealth SW Heart & Vascular Center

  • Cardiovascular Disease Physician
  • Vancouver, WA
  • NPI 1003194911

  Hospital

  Care Compare affiliation
• Peacehealth

  dba PeaceHealth Southwest Medical Center

  • General Acute Care Hospital
  • Vancouver, WA
  • NPI 1134178999
  Care Compare affiliation
• Yakima Valley Memorial Hospital Association

  dba MultiCare Yakima Memorial Hospital

  • General Acute Care Hospital
  • Yakima, WA
  • NPI 1053373480
  Care Compare affiliation
• Asante

  dba Asante Rogue Regional Medical Center

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1770587107
  Care Compare affiliation
• County of Santa Clara

  dba Inpatient Acute/Outpatient Facility Services

  • General Acute Care Hospital
  • San Jose, CA
  • NPI 1063406551
  Care Compare affiliation
• St. Joseph Health Northern California, LLC

  dba Providence Santa Rosa Memorial Hospital

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1134152549
  Care Compare affiliation

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1437356268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19020 33RD AVE W STE 210",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980364748",
            "telephone_number": "425-563-1500",
            "fax_number": "425-563-1374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19020 33RD AVE W STE 210",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "98036",
            "telephone_number": "425-563-1500",
            "fax_number": "425-563-1501"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 Welch Road",
            "address_2": "LPCH Radiology",
            "address_purpose": "LOCATION",
            "city": "Stanford",
            "state": "CA",
            "postal_code": "943055654",
            "country_code": "US",
            "telephone_number": "650-725-2548",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Parnassus Ave",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "94143",
            "country_code": "US",
            "telephone_number": "415-476-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 Parnassus Ave",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "94143",
            "country_code": "US",
            "telephone_number": "415-476-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACKENZIE",
        "first_name": "JOHN",
        "middle_name": "DEWOLFE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-27",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "CA",
            "license": "A99500",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A99500",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "WA",
            "license": "MD60942783",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "WA",
            "license": "MD60942783",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I-EVERGREEN RADIA",
            "identifier": "0408813",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I-SEATTLE RADIOLOGY",
            "identifier": "0408817",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I-RADIA REST OF WA",
            "identifier": "0408810",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I-RADIA KING COUNTY",
            "identifier": "0408811",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I-SOUTH SOUND RADIOLOGY",
            "identifier": "0408816",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "L&I-SWEDISH RADIA EDMONDS",
            "identifier": "0408812",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1091767",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marie Choquette Maccoy, LICSW, CDP, CMHS, MH
• Steven Masuo Machida, D.D.S.
• Veronica Prajedez Macias
• Madison Kalen Macintosh
• Mary Mack, DNP
• James D Macon, M.D.
• Rachel Madding, LMHC
• Christina M Madelyn, LCSW
• Julie Madsen, LMFT
• Shawn Marie Madziwa, ARNP, FNP-C, RN

• Pediatric Radiology Physician in Lynnwood, WA
• Providers in Lynnwood, WA by specialty
• Pediatric Radiology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; 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.