Brandon Edwin Mackenzie, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601004002 Issued in MI

Practice address

44199 Dequindre
Suite 250
Troy, MI 48085

Phone

(248) 879-8441

Fax

(248) 879-6841

NPI assigned

Mar 9, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Michigan Orthopaedic Spine Surgeons PC

  • Orthopaedic Surgery Physician
  • Rochester Hills, MI
  • NPI 1972868321
  Medicare reassignment
• Great Lakes Surgical Assistants, PLLC

  • Surgical Physician Assistant
  • Troy, MI
  • NPI 1558653303
  NPD (past) Authorized official

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

{
    "created_epoch": "1141862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223424000000",
    "number": "1659349348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44199 DEQUINDRE",
            "address_2": "SUITE 250",
            "city": "TROY",
            "state": "MI",
            "postal_code": "48085",
            "telephone_number": "248-879-8441",
            "fax_number": "248-879-6841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44199 DEQUINDRE",
            "address_2": "SUITE 250",
            "city": "TROY",
            "state": "MI",
            "postal_code": "48085",
            "telephone_number": "248-879-8441",
            "fax_number": "248-879-6841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKENZIE",
        "first_name": "BRANDON",
        "middle_name": "EDWIN",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-09",
        "last_updated": "2008-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601004002",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Macdonald
• Jessica M Macdougall, PA
• Angela Catherine Maceri
• Carlie Maceri, PA-C
• Alleda E Mack, MD
• James C Mackenzie, MD
• Denise Frances Mackey, MD
• Morgan Macklem
• Matthew Maclellan, TLLP
• Brittany Maclennan, D.C.

• Physician Assistant in Troy, MI
• Providers in Troy, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.