Alisia Kaye Macioch, M.S., LAT, ATC

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

3138 Issued in MN

Practice address

1240 County Road B2 W
Roseville, MN 55113-4338

Phone

(651) 301-2279

NPI assigned

May 11, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772668800000",
    "number": "1568998482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 6TH AVE S",
            "city": "SOUTH SAINT PAUL",
            "state": "MN",
            "postal_code": "550752624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 COUNTY ROAD B2 W",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "551134338",
            "telephone_number": "651-301-2279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACIOCH",
        "first_name": "ALISIA",
        "middle_name": "KAYE",
        "credential": "M.S., LAT, ATC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "MN",
            "license": "3138",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Luxottica of America Inc.
• Mai Tia Ly, REGISTERED NURSE
• Senyi Ly, DC
• Laura Lyman, LICSW
• Jeremiah Lynch, PA-C
• Lisabeth Houston Mackall, MS, CCC-SLP
• Karen L Mackenzie, MD
• Maria Mae Mahady, RD, LD
• Iqra Abdullahi Mahamud
• Zahra Abdi Mahamud

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Roseville, MN
• Providers in Roseville, MN by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.