Individual provider Active NPI

John Albert Macri IV, PA-C

  • Physician Assistant
  • Hazle Township, PA
National Provider Identifier
1669130373
Registry record updated Aug 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
OA007280 Issued in PA
Practice address
1201A N Church St Ste 103
Hazle Township, PA 18202-1479
Phone
(570) 455-8544
Fax
(570) 455-8554
NPI assigned
Nov 30, 2021
Last updated
Aug 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X MA063264 PA
Physician Assistant 363A00000X OA007280 PA Primary

Addresses

Primary practice location

1201A N Church St Ste 103
Hazle Township, PA 18202-1479

Mailing address

1201A N Church St Ste 103
Hazle Township, PA 18202-1479
Phone (570) 455-8544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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

Enrollment IDStateProvider typePAC IDDetails
I20220112000640 PA Practitioner - Physician Assistant 4880086438 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain View Orthopaedics and Associates PCGroup PAC ID 8426014267, 3 clinicians

Practice addresses (Care Compare)

1201 A N Church St
Suite 103
Hazle Township, PA 18202-1479
Phone (570) 455-7108

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
OA007280PAMDPhysician Assistant
MA063264PAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic CurrentSince Jan 17, 2022 Accepting new patients
Geisinger Clinic CurrentSince Jan 17, 2022 Accepting new patients

Locations

100 N Academy Ave
Danville, PA 17822

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1638230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755216000000",
    "number": "1669130373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201A N CHURCH ST STE 103",
            "city": "HAZLE TOWNSHIP",
            "state": "PA",
            "postal_code": "182021479",
            "telephone_number": "570-455-8544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201A N CHURCH ST STE 103",
            "city": "HAZLE TOWNSHIP",
            "state": "PA",
            "postal_code": "182021479",
            "telephone_number": "570-455-8544",
            "fax_number": "570-455-8554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACRI",
        "first_name": "JOHN",
        "middle_name": "ALBERT",
        "name_suffix": "IV",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-30",
        "last_updated": "2025-08-15",
        "certification_date": "2025-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "PA",
            "license": "MA063264",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA007280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hazle Township, PA

Sources for this page

Verify at the official NPI Registry.