NPIMap

Individual provider Active NPI

Macey Brooke Cartrite, DDS, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Mansfield, TX
National Provider Identifier
1992153985
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
36413 Issued in TX
Practice address
1752 Broad Park Cir N Ste 100
Mansfield, TX 76063-7824
Phone
(817) 225-3223
NPI assigned
May 31, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Orofacial Pain Dentistry 1223X2210X 36413 TX
Surgery Physician 208600000X T6532 TX
Student in an Organized Health Care Education/Training Program 390200000X
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 36413 TX Primary

Addresses

Primary practice location

1752 Broad Park Cir N Ste 100
Mansfield, TX 76063-7824

Mailing address

2120 Olive St Apt 809
Dallas, TX 75201-2456
Phone (806) 683-6674

Other practice location 1

2120 Olive Street
Suite 809
Dallas, TX, TX 75201
Phone (806) 683-6674

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Nov 9, 2022 through Nov 9, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
36413TXMDClinical Psychologist
T6532TXMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Oral Surgery and Implants Current Accepting new patients
Beyond 35 LLC Oral and Maxillofacial Surgery CurrentSince May 28, 2023 Accepting new patients
Douglas P. Sinn, DDS, PA Oral and Maxillofacial Surgery PastSince May 28, 2023 Accepting new patients

Locations

1752 Broad Park Cir N
Ste 100
Mansfield, TX 76063
Phone (817) 225-3223

Interoperability endpoints

  • Direct secure messaging: mcartrite66928@direct.phhs.org

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": "1464652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1992153985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 OLIVE ST APT 809",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752012456",
            "telephone_number": "806-683-6674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1752 BROAD PARK CIR N STE 100",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760637824",
            "telephone_number": "817-225-3223"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2120 Olive Street",
            "address_2": "Suite 809",
            "address_purpose": "LOCATION",
            "city": "Dallas, TX",
            "state": "TX",
            "postal_code": "75201",
            "country_code": "US",
            "telephone_number": "806-683-6674",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARTRITE",
        "first_name": "MACEY",
        "middle_name": "BROOKE",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-31",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "TX",
            "license": "36413",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "T6532",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "36413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, TX

Sources for this page

Verify at the official NPI Registry.