Timothy A Mackie, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

1718 Issued in CO

Practice address

13631 Colorado Blvd
Thornton, CO 80602-7051

Phone

(303) 252-2960

Fax

(303) 252-2964

NPI assigned

Nov 9, 2005

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

Other identifiers 2

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

Physician Assistant

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Poudre Valley Medical Group LLCGroup PAC ID 9638208549, 2,425 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Colorado Hospital Authority Hospital, Aurora, CO, CCN 060024

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1225356868
  Medicare reassignment Care Compare group
• Poudre Valley Medical Group, LLC

  • General Practice Physician
  • Loveland, CO
  • NPI 1366763260
  NPD
• Colorado Orthopedic Specialists

  • Specialist
  • Denver, CO
  • NPI 1841230679
  NPD (past)
• Uchealth Community Services

  • Physical Therapist
  • Englewood, CO
  • NPI 1841740693
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• University of Colorado Hospital Authority

  • General Acute Care Hospital
  • Arvada, CO
  • NPI 1013407865
  Care Compare affiliation
• University of Colorado Hospital Authority

  • General Acute Care Hospital
  • Boulder, CO
  • NPI 1063071033
  Care Compare affiliation
• University of Colorado Hospital Authority

  • General Acute Care Hospital
  • Lone Tree, CO
  • NPI 1063072932
  Care Compare affiliation
• University of Colorado Hospital Authority

  • General Acute Care Hospital
  • Denver, CO
  • NPI 1083274930
  Care Compare affiliation
• University of Colorado Hospital Authority

  • General Acute Care Hospital
  • Denver, CO
  • NPI 1154980118
  Care Compare affiliation
• University of Colorado Hospital Authority

  • General Acute Care Hospital
  • Lone Tree, CO
  • NPI 1265092126
  Care Compare affiliation
• University of Colorado Hospital Authority

  • General Acute Care Hospital
  • Highlands Ranch, CO
  • NPI 1285293274
  Care Compare affiliation
• University of Colorado Hospital Authority

  • General Acute Care Hospital
  • Lone Tree, CO
  • NPI 1306406285
  Care Compare affiliation
• University of Colorado Hospital Authority

  • General Acute Care Hospital
  • Denver, CO
  • NPI 1356901235
  Care Compare affiliation
• University of Colorado Hospital Authority

  • General Acute Care Hospital
  • Thornton, CO
  • NPI 1366932162
  Care Compare affiliation
• University of Colorado Hospital Authority

  • General Acute Care Hospital
  • Denver, CO
  • NPI 1386267714
  Care Compare affiliation
• University of Colorado Hospital Authority

  • General Acute Care Hospital
  • Denver, CO
  • NPI 1407479975
  Care Compare affiliation

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1689655466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2695 ROCKY MOUNTAIN AVE STE 150",
            "city": "LOVELAND",
            "state": "CO",
            "postal_code": "805389071",
            "telephone_number": "970-624-4451",
            "fax_number": "970-490-4199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13631 COLORADO BLVD",
            "city": "THORNTON",
            "state": "CO",
            "postal_code": "806027051",
            "telephone_number": "303-252-2960",
            "fax_number": "303-252-2964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKIE",
        "first_name": "TIMOTHY",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-09",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "CO",
            "license": "1718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER COMMERCIAL NUMBER",
            "identifier": "019498",
            "state": "CO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "12839701",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodcom/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "CAREQUALITY",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "8383 W Alameda Ave",
            "city": "Lakewood",
            "state": "CO",
            "country_code": "US",
            "postal_code": "802263007",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David Macaulay
• Christopher Macey
• Anastacia Macias, RN
• Lisa Mack
• Julie L Mackie, CD(DONA)
• Caroline Maclay, MA
• Thomas Alan Macnabb
• Made LLC
• Madison Street Provider Network Inc
• Danielle Madonia, B.A.

• Surgical Physician Assistant in Thornton, CO
• Providers in Thornton, CO by specialty
• Surgical Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; 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.
• 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.