Individual provider Active NPI

Avery Mackenzie, M.D.

  • Emergency Medicine Physician
  • Montrose, CO
National Provider Identifier
1942563432
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
55088 Issued in CO
Practice address
800 S 3Rd St
Montrose, CO 81401-4212
Phone
(970) 240-7180
NPI assigned
Jun 19, 2012
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 55088 CO Primary

Addresses

Primary practice location

800 S 3Rd St
Montrose, CO 81401-4212

Mailing address

PO Box 403
Ridgway, CO 81432-0403
Phone (978) 835-2640

Other practice location 1

777 Bannock St
Mail code 0108
Denver, CO 80204-4507
Phone (303) 436-7142

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20150921002445 CO Practitioner - Emergency Medicine 0840507034 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Montrose Memorial Hospital, IncGroup PAC ID 1658272992, 148 clinicians

Practice addresses (Care Compare)

800 S 3Rd St
Montrose, CO 81401-4212
Phone (970) 249-2211

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.89 of 100Reported as apm
Quality
86.88
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55088COMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Montrose Memorial Hospital, Inc CurrentSince Jul 1, 2016 Accepting new patients
Montrose Memorial Hospital, Inc CurrentSince Jul 1, 2016 Accepting new patients
Montrose Memorial Hospital, Inc Emergency Medicine Current Accepting new patients

Locations

800 S 3rd St
Montrose, CO 81401
Phone (970) 240-2211

Organizations & group practices 3

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 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": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1942563432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 403",
            "city": "RIDGWAY",
            "state": "CO",
            "postal_code": "814320403",
            "telephone_number": "978-835-2640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 S 3RD ST",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814014212",
            "telephone_number": "970-240-7180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "777 Bannock St",
            "address_2": "Mail code 0108",
            "address_purpose": "LOCATION",
            "city": "Denver",
            "state": "CO",
            "postal_code": "802044507",
            "country_code": "US",
            "telephone_number": "303-436-7142",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACKENZIE",
        "first_name": "AVERY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-19",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "55088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montrose, CO

Sources for this page

Verify at the official NPI Registry.