Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Timothy A Mackie, PA

Individual provider Surgical Physician Assistant · NPI 1689655466

Timothy A Mackie, PA is a Physician Assistant in Thornton, Colorado. Qualified in 2000, 26 years ago. Practices with Poudre Valley Medical Group LLC, a 2,416-clinician group and accepts Medicare assignment. Licensed in Colorado.

Years since qualifying
26
Licensed in
CO
In the registry since
2005
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

13631 Colorado Blvd
Thornton, CO 80602-7051
Phone: (303) 252-2960
Fax: (303) 252-2964
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 1718 (CO)

Record details

NPI number1689655466
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedNovember 9, 2005
Last updated in NPPESNovember 3, 2021
Certification dateNovember 3, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2000 (26 years in practice)
Group practice Poudre Valley Medical Group Llc — 2416 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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