NPIMap

Individual provider Active NPI

Craig Andrew Mackaness, DO

  • Nephrology Physician
  • Allentown, PA
National Provider Identifier
1871720375
Registry record updated Jun 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
OS015563 Issued in PA
Practice address
1230 S Cedar Crest Blvd
Suite 301
Allentown, PA 18103-6367
Phone
(610) 432-4529
NPI assigned
Jun 11, 2009
Last updated
Jun 19, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X OS015563 PA Primary

Addresses

Primary practice location

1230 S Cedar Crest Blvd
Suite 301
Allentown, PA 18103-6367

Mailing address

1230 S Cedar Crest Blvd
Suite 301
Allentown, PA 18103-6367
Phone (610) 432-4529

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20180801002361 SC Practitioner - Internal Medicine 5799948808 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Philadelphia College of Osteopathic Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
24 On Physicians of SC LLCGroup PAC ID 5890127344, 136 clinicians

Practice addresses (Care Compare)

316 Calhoun St
Charleston, SC 29401-1113
Phone (843) 724-2901

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS015563PAMDNephrology Physician
51973SCMDGlaucoma Specialist (Ophthalmology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Roper Saint Francis Physicians Network CurrentSince Jul 23, 2018 Accepting new patients
Roper Saint Francis Physicians Network Current Accepting new patients
24 On Physicians of SC, LLC CurrentSince Oct 1, 2019 Accepting new patients
Roper Saint Francis Physicians Network CurrentSince Jul 23, 2018 Accepting new patients
Roper Hospital, Inc Past Accepting new patients
Kidney Care Specialists LLC Nephrology PastSince Mar 1, 2021 Accepting new patients

Locations

316 Calhoun St
Charleston, SC 29401
Phone (843) 724-2000

8536 Palmetto Commerce Pkwy
Ste 401
Ladson, SC 29456
Phone (843) 203-2260

2075 Eagle Landing Blvd
North Charleston, SC 29406
Phone (843) 797-5747

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Roper Hospital IncCharleston, SC, CCN 420087 Hospital Corporate Director Jan 1, 2021
Roper Hospital IncCharleston, SC, CCN 42T087 Hospital Corporate Director Jan 1, 2021
Roper HospiceLadson, SC, CCN 421612 Hospice Corporate Director Jan 1, 2021

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 11

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": "1244678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434672000000",
    "number": "1871720375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 S CEDAR CREST BLVD",
            "address_2": "SUITE 301",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036367",
            "telephone_number": "610-432-4529",
            "fax_number": "610-432-2206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 S CEDAR CREST BLVD",
            "address_2": "SUITE 301",
            "city": "ALLENTOWN",
            "state": "PA",
            "postal_code": "181036367",
            "telephone_number": "610-432-4529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKANESS",
        "first_name": "CRAIG",
        "middle_name": "ANDREW",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-11",
        "last_updated": "2015-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "PA",
            "license": "OS015563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Allentown, PA

Sources for this page

Verify at the official NPI Registry.