Individual provider Active NPI

Theodore I Macey, MD PA

  • Orthopaedic Surgery Physician
  • Fort Walton Beach, FL
National Provider Identifier
1952305484
Registry record updated Feb 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
ME44008 Issued in FL
Practice address
1034 Mar Walt Dr Ste 100
Fort Walton Beach, FL 32547-6645
Phone
(850) 863-2153
Fax
(850) 315-9350
NPI assigned
Jun 13, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X ME44008 FL Primary

Addresses

Primary practice location

1034 Mar Walt Dr Ste 100
Fort Walton Beach, FL 32547-6645

Mailing address

1034 Mar Walt Dr Ste 100
Fort Walton Beach, FL 32547-6645
Phone (850) 863-2153

Other identifiers 4

IdentifierTypeStateIssuer
041896000MedicaidFL
207X00000XOtherFLTAXONOMY NUMBER
200030432OtherFLRR MEDICARE
DC6653OtherFLRR MEDICARE GROUP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20041116000240 FL Practitioner - Orthopedic Surgery 6305742305 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Theodore I Macey MD PA CurrentSince Aug 24, 2004 Accepting new patients
Orthopaedic Associates, PA Orthopaedic Surgery CurrentSince Jul 20, 2010 Accepting new patients
Orthopaedic Associates PA Orthopaedic Surgery CurrentSince Jun 14, 2004 Accepting new patients

Locations

36474C Emerald Coast Pkwy
Ste 3101
Destin, FL 32541
Phone (850) 344-1646

1034 Mar Walt Dr
Unit 100
Ft Walton Bch, FL 32547
Phone (850) 315-9210

554 Twin Cities Blvd
Ste D
Niceville, FL 32578
Phone (850) 315-9210

Interoperability endpoints

  • Direct secure messaging: tmacey@direct.orthoassociates.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360800000000",
    "number": "1952305484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 MAR WALT DR STE 100",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476645",
            "telephone_number": "850-863-2153",
            "fax_number": "850-315-9350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 MAR WALT DR STE 100",
            "city": "FORT WALTON BEACH",
            "state": "FL",
            "postal_code": "325476645",
            "telephone_number": "850-863-2153",
            "fax_number": "850-315-9350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACEY",
        "first_name": "THEODORE",
        "middle_name": "I",
        "name_prefix": "Dr.",
        "credential": "MD PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2013-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "FL",
            "license": "ME44008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "041896000",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY NUMBER",
            "identifier": "207X00000X",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "200030432",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP",
            "identifier": "DC6653",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Walton Beach, FL

Sources for this page

Verify at the official NPI Registry.