Individual provider Active NPI

Mackenzie Landin, M.D.

  • Surgery Physician
  • Phoenix, AZ
National Provider Identifier
1740695337
Registry record updated Jun 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
2019-01762 Issued in NC
Practice address
1441 N 12TH St FL 2
Phoenix, AZ 85006-2837
Phone
(602) 521-3050
NPI assigned
Jun 23, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 125064599 IL
Surgery Physician 208600000X 61110 AZ
Surgery Physician 208600000X 2019-01762 NC Primary

Addresses

Primary practice location

1441 N 12TH St FL 2
Phoenix, AZ 85006-2837

Mailing address

1441 N 12TH St FL 2
Phoenix, AZ 85006-2837
Phone (602) 521-3050

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200831000460 AZ Practitioner - General SurgeryPractitioner - Other (Physician) 8628375581 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Medical College of Wisconsin, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1441 N 12TH St
FL 2
Phoenix, AZ 85006-2837
Phone (844) 242-4664

Hospital & facility affiliations

  • Banner - University Medical Center Phoenix Hospital, Phoenix, AZ, CCN 030002

Merit-based Incentive Payment System (MIPS)

Final score
82.85 of 100Reported as group
Quality
69.75
Promoting interoperability
98
Improvement activities
40
Cost
68.18

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125064599ILMDSurgery Physician
2019-01762NCMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Banner - University Physician Specialists LLC CurrentSince Sep 1, 2020 Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince May 1, 2021 Accepting new patients
Banner Hospital Based Physicians Arizona LLC Current Accepting new patients
Banner - University Physician Specialists LLC CurrentSince Sep 1, 2020 Accepting new patients
Banner Hospital Based Physicians Arizona LLC CurrentSince May 1, 2021 Accepting new patients
Banner - University Medical Center Phoenix Past Accepting new patients

Locations

1400 S Dobson Rd
Mesa, AZ 85202
Phone (480) 412-3000

1441 N 12th St
Fl 3
Phoenix, AZ 85006
Phone (602) 521-5700

1300 N 12th St
Ste 508
Phoenix, AZ 85006
Phone (602) 839-3927

1441 N 12th St
Fl 2AND3
Phoenix, AZ 85006

1441 N 12th St
Fl 2
Phoenix, AZ 85006
Phone (602) 521-5180

1111 E McDowell Rd
Phoenix, AZ 85006
Phone (602) 239-2000

1441 N 12th St
Ste 3
Phoenix, AZ 85006

4200 E Camelback Rd
Ste 202
Phoenix, AZ 85018
Phone (602) 229-2150

Organizations & group practices 6

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 1

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": "1403481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591142400000",
    "number": "1740695337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1441 N 12TH ST FL 2",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062837",
            "telephone_number": "602-521-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 N 12TH ST FL 2",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850062837",
            "telephone_number": "602-521-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANDIN",
        "first_name": "MACKENZIE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-23",
        "last_updated": "2020-06-03",
        "certification_date": "2020-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "125064599",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "61110",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "2019-01762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.