PATRICK D MACKEN MD NPI 1003872417

Internal Medicine (Nephrology) in Eau Claire, WI

About PATRICK MACKEN

Patrick Macken is a provider in Eau Claire, WI. The NPI number assigned to this provider is 1003872417. The practitioner's primary taxonomy code is Internal Medicine (207RN0300X). The provider is registered as an individual and their NPI record was last updated 5 years ago.

NPI1003872417 Additional informationCallout TooltipNational Provider Indentifier (NPI)
The 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.
Provider Name PATRICK D MACKEN MD
Provider Location Address1425 ELDERBERRY LN EAU CLAIRE, WI 54701 Additional informationCallout TooltipProvider location address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Mailing Address1425 ELDERBERRY LN EAU CLAIRE, WI 54701 Additional informationCallout TooltipProvider mailing address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.
GenderMale
NPI Entity TypeIndividual Additional informationCallout TooltipEntity type code
The code describing the type of health care provider that is being assigned an NPI.
Codes are:
1 = (Person): individual human being who furnishes health care;
2 = (Non-person): entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor?Yes
Is Organization Subpart?N/A Additional informationCallout TooltipWhat is a subpart?
Subparts are the components and separate physical locations of organization health care providers. Examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.
Enumeration Date04-25-2006 Additional informationCallout TooltipProvider enumeration date
The date the provider was assigned a unique identifier (assigned an NPI)
Last Update Date01-09-2013 Additional informationCallout TooltipLast update date
The date that a record was last updated or changed.

Business Address

PATRICK D MACKEN MD
1425 ELDERBERRY LN
EAU CLAIRE, WI
ZIP 54701
Phone: (715) 832-9801
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Mailing Address

PATRICK D MACKEN MD
1425 ELDERBERRY LN
EAU CLAIRE, WI
ZIP 54701
Phone: (715) 832-9801

Primary Taxonomy

Taxonomy Code207RN0300X Additional informationCallout TooltipPrimary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
SpecializationNephrology
License No.20307
License StateWI
Taxonomy DescriptionAn internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
0047 20195MEDICARE ID-TYPE UNSPECIFIED (04)WI
31073900MEDICAID (05)WI
B54732MEDICARE UPIN (02)

Map Location


PATRICK D MACKEN MD address is 1425 ELDERBERRY LN EAU CLAIRE, WI 54701