Justin Adam Mackinnon, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

2711461 Issued in NY

Practice address

50 Leroy St
Department of Emergency Medicine
Potsdam, NY 13676-1786

Phone

(315) 265-3300

NPI assigned

Apr 6, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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 1

Merit-based Incentive Payment System (MIPS)

Final score

98.56 of 100Reported as apm

Quality

87.76

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

98.56 of 100Reported as apm

Quality

87.76

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

98.56 of 100Reported as apm

Quality

87.76

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Canton-Potsdam Hospital

  • General Acute Care Hospital
  • Potsdam, NY
  • NPI 1568548782
  Medicare reassignment NPD
• Gouverneur Hospital

  • Critical Access Hospital
  • Gouverneur, NY
  • NPI 1295156412
  Medicare reassignment NPD
• Gouverneur Hospital

  • Critical Access Hospital
  • Gouverneur, NY
  • NPI 1629409925
  Medicare reassignment NPD
• Massena Hospital Inc

  • Critical Access Hospital
  • Massena, NY
  • NPI 1972604460
  Medicare reassignment
• Canton-Potsdam Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Potsdam, NY
  • NPI 1114104445
  NPD
• Massena Hospital, Inc

  • Medicare Defined Swing Bed Hospital Unit
  • Massena, NY
  • NPI 1619756640
  NPD

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

{
    "created_epoch": "1333670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433721600000",
    "number": "1447516224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 LEROY ST",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136761786",
            "telephone_number": "315-265-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 LEROY ST",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE",
            "city": "POTSDAM",
            "state": "NY",
            "postal_code": "136761786",
            "telephone_number": "315-265-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKINNON",
        "first_name": "JUSTIN",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-06",
        "last_updated": "2015-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NY",
            "license": "2711461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenelly Lozada-Cruz, MD
• James P Lyons, M.D.
• M B Kayani Physician PC
• M S Tiger Incorporated
• Heather Mackinnon
• Margaret Maguire, R.D.
• Katelin Lauren Maki, PHARM D
• Molly Jane Malone-Trim, PHYSICIAN ASSISTANT
• Amy B Mangual, REGISTERED NURSE
• Glauco Michael Maresca, MD

• Emergency Medicine Physician in Potsdam, NY
• Providers in Potsdam, NY by specialty
• Emergency Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; 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.