Sean Macko

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT013669 Issued in GA

Practice address

80 Seven Hills Blvd Ste 107
Dallas, GA 30132-0575

Phone

(678) 402-0515

NPI assigned

Sep 10, 2018

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

Enrolled in GA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians

Sports Medicine South of Gwinnett LLCGroup PAC ID 9335566967, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Northside Surgical Professional Services LLC

  • Surgery Physician
  • Atlanta, GA
  • NPI 1356630990
  Medicare reassignment Care Compare group NPD
• Sports Medicine South of Gwinnett LLC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Lawrenceville, GA
  • NPI 1265053110
  Medicare reassignment Care Compare group
• Kennestone Hospital, Inc

  dba Wellstar Kennestone Hospital Inpatient Psych Unit

  • Psychiatric Hospital Unit
  • Atlanta, GA
  • NPI 1689361438
  NPD (past)

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

{
    "created_epoch": "1536537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536537600000",
    "number": "1811470545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 724557",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311391557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 SEVEN HILLS BLVD STE 107",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301320575",
            "telephone_number": "678-402-0515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKO",
        "first_name": "SEAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-10",
        "last_updated": "2018-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT013669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• LTHW Surgical, LLC
• Luke Medical Transport LLC
• Lyfe Passion Transits LLC
• Breanna Lynch
• Cynthia Macfarlane, D.C.
• Manuel Physical Therapy and Sports Performance
• Rolando E. Manuel Jr.
• Paola Marquez
• Martin Medical SLP LLC
• Charlene Samone Martin, M.S. CCC-SLP

• Physical Therapist in Dallas, GA
• Providers in Dallas, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2018; 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.