Machaon Diagnostics, Inc.

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

05D1019489 Issued in CA

Legal business name

MACHAON DIAGNOSTICS, INC.

Practice address

2023 Eighth St
Berkeley, CA 94710-2026

Phone

(510) 839-5600

Fax

(510) 839-6153

NPI assigned

Jan 2, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Mike Penfield Ero, MT, CLS

Title

Lab Manager

Phone

(510) 839-5600

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668038400000",
    "number": "1669539243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2023 EIGHTH ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947102026",
            "telephone_number": "510-839-5600",
            "fax_number": "510-839-6153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2023 EIGHTH ST",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947102026",
            "telephone_number": "510-839-5600",
            "fax_number": "510-839-6153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MACHAON DIAGNOSTICS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-02",
        "last_updated": "2022-11-10",
        "certification_date": "2022-11-10",
        "status": "A",
        "authorized_official_last_name": "ERO",
        "authorized_official_first_name": "MIKE",
        "authorized_official_middle_name": "PENFIELD",
        "authorized_official_title_or_position": "LAB MANAGER",
        "authorized_official_telephone_number": "510-839-5600",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MT, CLS"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CA",
            "license": "05D1019489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Keith Macdonald, MA, PSY.D.
• Philip Todd Maceachron, PSY.D.
• Resham Macfarlane
• Maya Macgibbon
• Nicole Machado-Potestio
• Mychal Verdad Macias
• Peter Macias
• Mack Jacob, DDS
• Robert Thomas Mack, MD
• Robert DS Mackay, M.D.

• Clinical Medical Laboratory in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Clinical Medical Laboratory in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.