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Deactivated NPI 1619070521 Deactivated / Inactive NPI Male Practitioner

Dr. Bert J Mackaman , BS, MD

Dermatology • Salem, OR

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Bert Mackaman has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 06, 2006
NPI Deactivation Date March 08, 2021
Total Practice Duration ~15 Years of Practice (2006 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. Bert Mackaman, BS, MD was a registered Dermatology practicing in Salem, OR. Throughout an active medical career spanning 15 years, Dr. Mackaman provided care at the practice location at 665 WINTER ST SE until profile deactivation on 2021-03-08.

Practice Location & Contact Primary Location

Practice Address

665 Winter St Se

Salem, OR 973095014

Telephone 5033634498
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dermatology in Salem, OR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 16.3 Yrs
State Avg: 21.5 Yrs
Regional Practice Density
17 Specialists

Practicing in Salem, OR (217 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dermatology Primary Specialty

NUCC Taxonomy Code: 207N00000X

State License OR MD 11104

A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Charles Wilson , MD

Emergency Medicine

NPI 1033211339

Doctor of Medicine (M.D.)

Matthew Jobson , MSN, RN, AGACNP-BC

Nurse Practitioner - Acute Care

NPI 1033774955

Master of Science in Nursing, Registered Nurse, Adult-Gerontology Acute Care Nurse Practitioner (Board Certified)

NPI 1053400713

Doctor of Medicine (M.D.)

Dr. Lazeni Koulibali , DO

Emergency Medicine

NPI 1063429777

Doctor of Osteopathic Medicine (D.O.)

Courtney Brozovich , PA-C

Physician Assistant

NPI 1083166037

Physician Assistant (Certified)

Dr. James Devorss , MD

Internal Medicine - Cardiovascular Disease

NPI 1083784896

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated March 08, 2021

Record deactivated on March 08, 2021

NPI Profile Active July 09, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 09, 2007

Registered at 665 WINTER ST SE, SALEM, OR 973095014 (Tel: 5033634498)

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Updated Business Mailing Address July 09, 2007

Registered at PO BOX 2267, SALEM, OR 973082267 (Tel: 5033634498)

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Provider Name / Credentials Updated July 09, 2007

Recorded as BERT MACKAMAN, B.S., M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 09, 2007

Dermatology (License #MD 11104 in OR)

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Initial NPI Registration & Enumeration September 06, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1619070521
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 06, 2006
Last Update: July 09, 2007
Deactivation Date: March 08, 2021

Mailing Address

Po Box 2267

Salem, OR 973082267

Phone: 5033634498

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.