NPIMap

Individual provider Active NPI

Mackenzie Fai, OD

  • Optometrist
  • Kalispell, MT
National Provider Identifier
1568086379
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
4264 Issued in MT
Practice address
175 Timberwolf Pkwy
Kalispell, MT 59901-1218
Phone
(406) 257-2020
Fax
(406) 257-5554
NPI assigned
Jun 8, 2020
Last updated
Oct 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 4264 MT Primary

Addresses

Primary practice location

175 Timberwolf Pkwy
Kalispell, MT 59901-1218

Mailing address

175 Timberwolf Pkwy
Kalispell, MT 59901-1218
Phone (406) 257-2020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211111000874 MT Practitioner - Optometry 7618399882 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glacier Eye Clinic PCGroup PAC ID 5193728293, 12 clinicians

Practice addresses (Care Compare)

175 Timberwolf Pkwy
Kalispell, MT 59901-1218
Phone (406) 257-2020

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.59 of 100Reported as group
Quality
100
Improvement activities
40
Cost
78.64

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4264MTMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Glacier Eye Clinic PC Optometrist CurrentSince Dec 1, 2021 Accepting new patients
Spec'D Out Eye Care, PS Optometrist CurrentSince Mar 11, 2025 Accepting new patients

Locations

175 Timberwolf Pkwy
Kalispell, MT 59901
Phone (406) 257-2020

101 NW 12th Ave
Ste 101
Battle Ground, WA 98604
Phone (360) 687-0755

Interoperability endpoints

  • Direct secure messaging: mfai@glaciereye.intellechartdirect.net

Organizations & group practices 2

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.

Hospital & facility affiliations 8

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": "1591574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1568086379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 TIMBERWOLF PKWY",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599011218",
            "telephone_number": "406-257-2020",
            "fax_number": "406-257-5554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 TIMBERWOLF PKWY",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599011218",
            "telephone_number": "406-257-2020",
            "fax_number": "406-257-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAI",
        "first_name": "MACKENZIE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-08",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MT",
            "license": "4264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalispell, MT

Sources for this page

Verify at the official NPI Registry.