MARCUS MACDONALD (NP) – Nurse Practitioner, NPI 1194471763

MARCUS MACDONALD (NP) is a healthcare provider. based in Redford, Michigan. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 4704314802 (MI). The NPI Number for MARCUS MACDONALD (NP) is 1194471763

Main info

Male
5 Years Of Experience
Accepts Medicare Assignment
Name
MARCUS MACDONALD (NP)
NPI
1194471763
Phone
(313) 948-3055
Address
14671 TELEGRAPH RD
Enumeration Date
23 February 2022
Last Update Date
23 February 2022

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5173339200
Graduation Year
2021 (5 years ago)
PAC ID
3577957943
Group Practice PAC ID
7214947902
Professional Enrollment ID
I20220301000573
Address ID
MI489124701LA505XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience32
Completeness75
Years active:4State licenses:1Digital endpointsOther names

8,105 NURSE PRACTITIONER in MI

Provider Addresses for MARCUS MACDONALD (NP)

  • 14671 TELEGRAPH RD

    REDFORD, MI 482393300

    Phone: (313) 948-3055

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2022-03-01

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220301000573INurse PractitionerMITBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 48239)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7214947902View full group profile
NameSpecialtyState
-MI
Physician AssistantMI
Physician AssistantMI
-MI
Physician AssistantMI
Physician AssistantCA
Physician AssistantMI
Physician AssistantMI
-MI
Physician AssistantOH

Reviews

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Frequently asked questions

Is MARCUS MACDONALD (NP) listed with a National Provider Identifier?
Yes — MARCUS MACDONALD (NP) has NPI 1194471763 on file in the registry.
Is MARCUS MACDONALD (NP) still an active registrant?
MARCUS MACDONALD (NP) carries an active NPI according to the public dataset.
What kind of doctor is MARCUS MACDONALD (NP)?
MARCUS MACDONALD (NP) is associated with Nurse Practitioner in the directory — Clinical services aligned with this taxonomy classification.
Is MARCUS MACDONALD (NP) associated with Redford?
Public fields place MARCUS MACDONALD (NP) around Redford, Michigan. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for MARCUS MACDONALD (NP) is noted as February 23, 2022 where the registry provides it.

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