Individual provider Active NPI

Michael Richard Macke, MD

  • Body Imaging Physician
  • Cedar Rapids, IA
National Provider Identifier
1518186980
Registry record updated Nov 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Body Imaging PhysicianTaxonomy code 2085B0100X
License
37225 Issued in IA
Practice address
1948 1St Avenue NE
Cedar Rapids, IA 52402-5321
Phone
(319) 364-0121
Fax
(319) 364-5684
NPI assigned
Apr 24, 2007
Last updated
Nov 6, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X 37225 IA Primary

Addresses

Primary practice location

1948 1St Avenue NE
Cedar Rapids, IA 52402-5321

Mailing address

1948 1St Ave NE
Cedar Rapids, IA 52402-5321
Phone (319) 364-0121

Other identifiers 2

IdentifierTypeStateIssuer
1518186980MedicaidIA
72198OtherIAWELLMARK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20070807000193 IA Practitioner - Diagnostic Radiology 8224129184 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
77.26 of 100Reported as group
Quality
69.68
Improvement activities
40
Cost
79.78

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
37225IAMDBody Imaging Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Regional Medical Center CurrentSince Sep 16, 2018 Accepting new patients
St Luke's Methodist Hospital Current Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients

Locations

625 L St
Fort Dodge, IA 50501
Phone (515) 574-3015

802 Kenyon Rd
Fort Dodge, IA 50501
Phone (515) 574-6565

Interoperability endpoints

  • Direct secure messaging: mmacke41017@direct.unitypoint.org

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1177372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446768000000",
    "number": "1518186980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1948 1ST AVE NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524025321",
            "telephone_number": "319-364-0121",
            "fax_number": "319-364-5684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1948 1ST AVENUE NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524025321",
            "telephone_number": "319-364-0121",
            "fax_number": "319-364-5684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKE",
        "first_name": "MICHAEL",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-24",
        "last_updated": "2015-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "IA",
            "license": "37225",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1518186980",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "72198",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

Verify at the official NPI Registry.