Individual provider Active NPI

Natalie Esilda Macke, OD

  • Optometrist
  • Fairbanks, AK
National Provider Identifier
1487921748
Registry record updated Mar 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
317 Issued in AK
Practice address
116 Minnie St
Fairbanks, AK 99701-3006
Phone
(907) 456-7760
Fax
(907) 451-7916
NPI assigned
Nov 30, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 317 AK Primary

Addresses

Primary practice location

116 Minnie St
Fairbanks, AK 99701-3006

Mailing address

116 Minnie St
Ste a
Fairbanks, AK 99701-3006
Phone (503) 804-4909

Other identifiers 1

IdentifierTypeStateIssuer
1576235MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, HI2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120103000208 AK Practitioner - Optometry 5890961452 Reassigns benefits to 3 organizations
I20160714001409 HI Practitioner - Optometry 5890961452 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Clinic of Fairbanks IncGroup PAC ID 7719878370, 7 clinicians

Practice addresses (Care Compare)

116 Minnie St
Fairbanks, AK 99701-3006
Phone (907) 456-7760

700 Katlian St
Suite C
Sitka, AK 99835-7359
Phone (907) 747-6644

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sitka Vision Clinic Optometrist CurrentSince Feb 1, 2025 Accepting new patients
Family Optometric Associates P.C. Optometrist CurrentSince Oct 29, 2015 Accepting new patients
Wayne T Hagerman OD PC Optometrist CurrentSince Oct 29, 2024 Accepting new patients
Eye Clinic of Fairbanks, Inc Optometrist CurrentSince Dec 1, 2011 Accepting new patients
Eye to Eye of Frederick Inc Optometrist Past Accepting new patients

Locations

116 Minnie St
Ste A
Fairbanks, AK 99701

116 Minnie St
Fairbanks, AK 99701
Phone (907) 456-7760

700 Katlian St
Ste C
Sitka, AK 99835
Phone (503) 640-3708

4725 Bougainville Dr
Honolulu, HI 96818
Phone (808) 312-3878

2060 Yellow Springs Rd
Ste 104
Frederick, MD 21702
Phone (301) 662-5474

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1322611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1520553600000",
    "number": "1487921748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 MINNIE ST",
            "address_2": "STE A",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997013006",
            "telephone_number": "503-804-4909",
            "fax_number": "907-451-7916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 MINNIE ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997013006",
            "telephone_number": "907-456-7760",
            "fax_number": "907-451-7916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKE",
        "first_name": "NATALIE",
        "middle_name": "ESILDA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-30",
        "last_updated": "2018-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AK",
            "license": "317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1576235",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

Verify at the official NPI Registry.