MICHAEL W MACKIE PHD A PROFESSIONAL CORP
NPI 1174385892
Psychologist - Forensic in Los Angeles, CA
About Michael W Mackie Phd A Professional Corp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MICHAEL W MACKIE PHD A PROFESSIONAL CORP (NPI 1174385892) is a healthcare organization registered as a forensic in Los Angeles, California and active in the NPI registry since January 2024. The organization lists Michael William Vincent Mackie, Owner Provider, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Michael W Mackie Phd A Professional Corp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Michael W Mackie Phd A Professional Corp, which bills Medicare for the services this clinician delivers.
Clinician (1)
Los Angeles, CA 90025
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Michael W Mackie Phd A Professional Corp's NPI number?
The NPI number for Michael W Mackie Phd A Professional Corp is 1174385892. It was assigned to this organization in the NPPES registry on January 29, 2024.
Where is Michael W Mackie Phd A Professional Corp located?
Michael W Mackie Phd A Professional Corp is located at 10700 Santa Monica Blvd Ste 300, Los Angeles, CA 90025. The listed phone number is (424) 465-2840.
What is Michael W Mackie Phd A Professional Corp's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Forensic, with taxonomy code 103TF0200X.
Is Michael W Mackie Phd A Professional Corp enrolled in Medicare?
Yes. Michael W Mackie Phd A Professional Corp is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Michael W Mackie Phd A Professional Corp?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Clinical Psychologist) reassigns their Medicare billing to Michael W Mackie Phd A Professional Corp. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Michael W Mackie Phd A Professional Corp was last updated on January 29, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Michael W Mackie Phd A Professional Corp · NPI 1174385892
Forensic organization in Los Angeles, California. Organization record, active in the CMS NPPES registry since January 29, 2024.
## Identity
- **NPI:** 1174385892 (Entity type: Organization)
- **Enumerated:** January 29, 2024
- **Primary specialty:** Psychologist - Forensic · taxonomy 103TF0200X
- **Organization subpart:** No
- **Authorized official:** Michael Mackie, OWNER PROVIDER
## Practice location
- **Address:** 10700 SANTA MONICA BLVD STE 300, Los Angeles, CA 90025-6587
- **Phone:** (424) 465-2840
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Clinical Psychologist) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 29, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1174385892) · Data from the CMS NPPES public registry.