Active NPI
Natalie Esilda Macke, OD
- Optometrist
- Fairbanks, AK
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 317
- 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
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 |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1576235 | Medicaid | AK |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AK, HI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
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
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 37 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sitka Vision Clinic | Optometrist | Current | Accepting new patients |
| Family Optometric Associates P.C. | Optometrist | Current | Accepting new patients |
| Wayne T Hagerman OD PC | Optometrist | Current | Accepting new patients |
| Eye Clinic of Fairbanks, Inc | Optometrist | Current | 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.
-
- Optometrist
- Frederick, MD
- NPI 1861683872
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2018; 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.