NPIMap

Organization Active NPI

David a Mackoul, M.D., P.a.

  • Pediatrics Physician
  • Cape Coral, FL
National Provider Identifier
1659389948
Registry record updated Nov 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
DAVID A MACKOUL, M.D., P.A.
Practice address
206 SE 16TH PL
Cape Coral, FL 33990-1329
Phone
(239) 829-1747
Fax
(239) 573-2006
NPI assigned
Aug 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2010

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

Authorized official

Name
David Mackoul, MDNPI 1871582056
Title
President
Phone
(239) 573-2001

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

206 SE 16TH PL
Cape Coral, FL 33990-1329

Mailing address

206 SE 16TH PL
Cape Coral, FL 33990-1329
Phone (239) 829-1747

Other identifiers 2

IdentifierTypeStateIssuer
258711402MedicaidFL
258711400MedicaidFL

Other names 1

  • MacKoul Pediatrics Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
10D0955541Mackoul Pediatrics206 SE 16TH Place, Cape Coral, FL 33990Certificate of waiverJan 3, 2027

National Provider Directory

National Provider Directory

Locations

206 SE 16th Pl
Cape Coral, FL 33990
Phone (239) 573-2001

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13514/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289174400000",
    "number": "1659389948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 SE 16TH PL",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339901329",
            "telephone_number": "239-829-1747",
            "fax_number": "239-573-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 SE 16TH PL",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339901329",
            "telephone_number": "239-829-1747",
            "fax_number": "239-573-2006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID A MACKOUL, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-03",
        "last_updated": "2010-11-08",
        "status": "A",
        "authorized_official_last_name": "MACKOUL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "239-573-2001",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258711402",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "258711400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MacKoul Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cape Coral, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.