Active NPI
Mackenzie Marie Wagaman
- Nurse Practitioner
- Rochester, MN
National Provider Identifier
1053290197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 14376
- Practice address
- 200 1St St SW
Rochester, MN 55905-0001 - Phone
- (507) 284-2511
- NPI assigned
- Sep 2, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 14376 | MN | Primary |
Addresses
Primary practice location
200 1St St SW
Rochester, MN 55905-0001
Mailing address
PO Box 860912
Provider Enrollment RST
Minneapolis, MN 55486-0912
Phone (507) 284-2511
Other practice location 1
5067 55th St NW
Rochester, MN 55901-3809
Phone (507) 292-7070
Other names 1
- Mackenzie Fritz
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mfritz1304602@ehrdirect.mayoclinicmsg.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1756771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786406400000",
"number": "1053290197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 860912",
"address_2": "PROVIDER ENROLLMENT RST",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554860912",
"telephone_number": "507-284-2511"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 1ST ST SW",
"city": "ROCHESTER",
"state": "MN",
"postal_code": "559050001",
"telephone_number": "507-284-2511"
}
],
"practiceLocations": [
{
"address_1": "5067 55th St NW",
"address_purpose": "LOCATION",
"city": "Rochester",
"state": "MN",
"postal_code": "559013809",
"country_code": "US",
"telephone_number": "507-292-7070",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WAGAMAN",
"first_name": "MACKENZIE",
"middle_name": "MARIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-09-02",
"last_updated": "2026-08-11",
"certification_date": "2026-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MN",
"license": "14376",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mfritz1304602@ehrdirect.mayoclinicmsg.org",
"affiliation": "N",
"address_1": "200 1st St SW",
"city": "Rochester",
"state": "MN",
"country_code": "US",
"postal_code": "559050001",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": [
{
"first_name": "MACKENZIE",
"last_name": "FRITZ",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Rochester, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.