NPIMap

Individual provider Active NPI

Roger Macy, MD

  • Family Medicine Physician
  • Brainerd, MN
National Provider Identifier
1689658635
Registry record updated Jan 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
32187 Issued in MN
Practice address
2024 S 6TH St
Brainerd, MN 56401-4529
Phone
(218) 828-7100
NPI assigned
Dec 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 32187 MN Primary

Addresses

Primary practice location

2024 S 6TH St
Brainerd, MN 56401-4529

Mailing address

523 N 3Rd St
Brainerd, MN 56401-3054
Phone (218) 828-7100

Other identifiers 1

IdentifierTypeStateIssuer
055873700MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060130000561 MN Practitioner - Family PracticePractitioner - Emergency Medicine 4284534124 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
University of Minnesota Medical School, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Josephs Medical CenterGroup PAC ID 8224948443, 238 clinicians

Practice addresses (Care Compare)

138 Main St S
Pierz, MN 56364-4400
Phone (320) 468-2587

280 Barclay Ave W
Pine River, MN 56474-5197
Phone (218) 587-4416

35205 County Rd
Suite 3
Crosslake, MN 56442-4057
Phone (218) 692-1010

4317 W Woodman St
Pequot Lakes, MN 56472-3473
Phone (218) 568-4416

523 N 3Rd St
Brainerd, MN 56401-3054
Phone (218) 828-7394

680 Pillsbury St N
Pillager, MN 56473-2507
Phone (218) 746-4527

Hospital & facility affiliations

  • Essentia Health St Joseph'S Medical Center Hospital, Brainerd, MN, CCN 240075

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Brainerd Medical Center Inc CurrentSince Jan 2, 2007 Accepting new patients
Brainerd Medical Center Inc. CurrentSince Jan 2, 2007 Accepting new patients
St Joseph'S Medical Center CurrentSince May 1, 2012 Accepting new patients
St. Joseph'S Medical Center Current Accepting new patients
Brainerd Medical Center Inc Current Accepting new patients
St. Joseph'S Medical Center CurrentSince May 1, 2012 Accepting new patients
St. Joseph'S Medical Center Past Accepting new patients

Locations

523 N 3rd St
Brainerd, MN 56401
Phone (218) 828-7394

13060 Isle Dr
Brainerd, MN 56425
Phone (218) 454-5920

2024 S 6th St
Brainerd, MN 56401
Phone (218) 828-2880

24087 Cuyuna St
Deerwood, MN 56444
Phone (218) 833-5160

400 E 3rd St
Duluth, MN 55805
Phone (218) 722-8364

680 Pillsbury St N
#C63360
Pillager, MN 56473
Phone (218) 746-4527

Organizations & group practices 7

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.

Hospital & facility affiliations 10

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

NPI Registry JSON

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452211200000",
    "number": "1689658635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 N 3RD ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564013054",
            "telephone_number": "218-828-7100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 S 6TH ST",
            "city": "BRAINERD",
            "state": "MN",
            "postal_code": "564014529",
            "telephone_number": "218-828-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACY",
        "first_name": "ROGER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2016-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "32187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "055873700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brainerd, MN

Sources for this page

Verify at the official NPI Registry.