Ethan Laghi Mackenzie, MD is a medicare enrolled "Student In An Organized Health Care Education/training Program" physician in Madison, Wisconsin. His current practice location is
600 Highland Ave, Madison, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(608) 263-6400.
Ethan Laghi Mackenzie is licensed to practice in * (Not Available) (license number ) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1710478573.
Physician's Profile
Full Name | Ethan Laghi Mackenzie |
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Gender | Male |
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Speciality | Student In An Organized Health Care Education/training Program |
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Location | 600 Highland Ave, Madison, Wisconsin |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1710478573
- Provider Enumeration Date: 05/28/2018
- Last Update Date: 09/02/2020
Medicare PECOS Information:
- PECOS PAC ID: 3577810464
- Enrollment ID: I20180724001518
Medical Identifiers
Medical identifiers for Ethan Laghi Mackenzie such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1710478573 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208200000X | Plastic Surgery | 73015-20 (Wisconsin) | Secondary |
390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ethan Laghi Mackenzie is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Ethan Laghi Mackenzie, MD 600 Highland Ave, Madison, WI 53792-0001 Ph: (608) 263-6400 | Ethan Laghi Mackenzie, MD 600 Highland Ave, Madison, WI 53792-0001 Ph: (608) 263-6400 |
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