Jeremy Michael Macko, M.D.

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

01071414A Issued in IN

Practice address

211 Arnold Ave Ste 15
Klamath Falls, OR 97603-2106

Phone

(541) 885-6392

NPI assigned

May 11, 2011

Last updated

Mar 8, 2022By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1305072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646697600000",
    "number": "1689966483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 ARNOLD AVE STE 15",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976032106",
            "telephone_number": "541-885-6392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 ARNOLD AVE STE 15",
            "city": "KLAMATH FALLS",
            "state": "OR",
            "postal_code": "976032106",
            "telephone_number": "541-885-6392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKO",
        "first_name": "JEREMY",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-11",
        "last_updated": "2022-03-08",
        "certification_date": "2022-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "IN",
            "license": "01071414A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elen Marie Mabe
• Dyllan E Mabou
• Randal A Machado, M.D.
• Stephanie Susan Machado
• Joseph Frank Macharro
• Nichole Maddock
• Tyler James Madsen, DDS
• Kenneth Kellogg Magee, M.D.
• Dawn Magnelli, CADCI
• Magnumorphic Health and Wellness, Inc.

• General Practice Physician in Klamath Falls, OR
• Providers in Klamath Falls, OR by specialty
• General Practice Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.