Individual provider Active NPI

Ceayee Mak, MD

  • Diagnostic Radiology Physician
  • Seattle, WA
National Provider Identifier
1548453459
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A95006 Issued in CA
Practice address
1959 NE Pacific St
C212, Box 356340
Seattle, WA 98195-0001
Phone
(206) 543-0065
NPI assigned
Aug 23, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X A95006 CA
Diagnostic Radiology Physician 2085R0202X A95006 CA Primary

Addresses

Primary practice location

1959 NE Pacific St
C212, Box 356340
Seattle, WA 98195-0001

Mailing address

PO Box 678510
Dallas, TX 75267-8510

Other practice location 1

1510 E Herndon Ave Ste 110
Fresno, CA 93720-3333
Phone (559) 450-6742

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20090924000396 CA Practitioner - Diagnostic Radiology 3971659434 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
New York Medical College, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Agnes Medical FoundationGroup PAC ID 7618946369, 161 clinicians

Practice addresses (Care Compare)

1510 E Herndon Ave
Suite 110
Fresno, CA 93720-3333
Phone (559) 450-6742

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40
Cost
88.21

Merit-based Incentive Payment System (MIPS)

Final score
85.57 of 100Reported as group
Quality
63.43
Promoting interoperability
98
Improvement activities
40
Cost
77.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A95006CAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Forefront Radiology Medical Group PC Diagnostic Radiology CurrentSince Oct 1, 2019 Accepting new patients
San Fernando Valley Interventional Radiology and Imaging Center CurrentSince Mar 14, 2018 Accepting new patients
LQMG Medical Group Inc. Current Accepting new patients
Saint Agnes Medical Foundation CurrentSince Jan 25, 2024 Accepting new patients

Locations

16311 Ventura Blvd
Ste 120
Encino, CA 91436
Phone (818) 817-7707

1510 E Herndon Ave
Ste 110
Fresno, CA 93720
Phone (559) 450-6742

6191 N Thesta St
Fresno, CA 93710
Phone (559) 435-7200

1221 E Spruce Ave
Fresno, CA 93720
Phone (559) 449-5777

7202 N Millbrook Ave
Ste 206
Fresno, CA 93720
Phone (559) 450-2300

1303 E Herndon Ave
Fresno, CA 93720
Phone (559) 449-3000

1516 Cotner Ave
Los Angeles, CA 90025
Phone (310) 445-2843

Interoperability endpoints

  • Direct secure messaging: cmak2712478@direct.trinity-health.org
  • FHIR API: https://api.platform.athenahealth.com/18604/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1548453459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 678510",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752678510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "address_2": "C212, BOX 356340",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981950001",
            "telephone_number": "206-543-0065"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1510 E Herndon Ave Ste 110",
            "address_purpose": "LOCATION",
            "city": "Fresno",
            "state": "CA",
            "postal_code": "937203333",
            "country_code": "US",
            "telephone_number": "559-450-6742",
            "fax_number": "559-450-6743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAK",
        "first_name": "CEAYEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-23",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "CA",
            "license": "A95006",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A95006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

Verify at the official NPI Registry.