Mackenzie Ann Bestul, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

13351 Issued in MN

Practice address

205 Wabasha St S
Saint Paul, MN 55107-1805

Phone

(952) 967-5584

NPI assigned

Apr 7, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mackenzie Ann Loutzenhiser Former name

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

St. Louis College of Physicians and Surgeons, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Group Health, Inc.

  • Multi-Specialty Clinic/Center
  • Minneapolis, MN
  • NPI 1710924683
  Medicare reassignment Care Compare group NPD (past)
• Ridgeview Medical Center

  • Certified Registered Nurse Anesthetist
  • Waconia, MN
  • NPI 1528364429
  Medicare reassignment
• Group Health, Inc.

  • Family Medicine Physician
  • Stillwater, MN
  • NPI 1245608454
  NPD
• Group Health, Inc.

  • General Practice Dentistry
  • Saint Paul, MN
  • NPI 1952042053
  NPD
• Ridgeview Medical Center

  • Diagnostic Radiology Physician
  • Waconia, MN
  • NPI 1811174923
  NPD
• Park Nicollet Clinic

  • Family Medicine Physician
  • St Louis Park, MN
  • NPI 1780621904
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1586217600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1124657549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 COMMERCE DR STE 200",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254925",
            "telephone_number": "651-968-5300",
            "fax_number": "651-646-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 WABASHA ST S",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551071805",
            "telephone_number": "952-967-5584"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4360 12th Ave E",
            "address_purpose": "LOCATION",
            "city": "Shakopee",
            "state": "MN",
            "postal_code": "553791955",
            "country_code": "US",
            "telephone_number": "651-968-5300",
            "fax_number": "651-646-0205",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1665 Utica Ave S Ste 100",
            "address_purpose": "LOCATION",
            "city": "St Louis Park",
            "state": "MN",
            "postal_code": "554163476",
            "country_code": "US",
            "telephone_number": "952-541-2500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BESTUL",
        "first_name": "MACKENZIE",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-07",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "13351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MACKENZIE",
            "last_name": "LOUTZENHISER",
            "middle_name": "ANN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Best Care FMS LLC
• Best Care LLC
• Best Care LLC
• Best Choice Home Healthcare, LLC
• Best in-Home Health Services
• Bethel University
• Bethesda Hospital, Healtheast
• Andrew Dennis Betlach, CPO
• Better Beginnings LLC
• Better Choices Better Communities

• Physician Assistant in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.