McKenzie Rae Masberg, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

13844 Issued in MN

Practice address

301 2ND St NE
New Prague, MN 56071-1709

Phone

(952) 758-4431

NPI assigned

Sep 29, 2021

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

• McKenzie Rae Neisen Former name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in SD, MN2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mayo Clinic Health System-Southwest Minnesota RegionGroup PAC ID 4688585771, 658 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mayo Clinic Health System New Prague Hospital, New Prague, MN, CCN 241361
• Mayo Clinic Health System - Mankato Hospital, Mankato, MN, CCN 240093
• Mayo Clinic Health System - Fairmont Hospital, Fairmont, MN, CCN 240166
• Minnesota Valley Health Center Inc Hospital, Le Sueur, MN, CCN 241375

Medicare enrollment (NPD)

Enrolled

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.

• Mayo Clinic Health System-Southwest Minnesota Region

  • Critical Access Hospital
  • New Prague, MN
  • NPI 1124035282

  MN

  Medicare reassignment Care Compare group NPD
• Mayo Clinic Health System-Southwest Minnesota Region

  • Multi-Specialty Clinic/Center
  • Mankato, MN
  • NPI 1578545422

  MN

  Medicare reassignment NPD (past)
• Sanford Clinic

  • Psychologist
  • Sioux Falls, SD
  • NPI 1396764254

  SD

  Medicare reassignment
• Sanford Health Network

  • Critical Access Hospital
  • Vermillion, SD
  • NPI 1790721280

  SD

  Medicare reassignment
• Mayo Clinic Health System-Southwest Minnesota Region

  • Multi-Specialty Clinic/Center
  • New Prague, MN
  • NPI 1477089407
  NPD
• Mayo Clinic Health System-Southwest Minnesota Region

  • Multi-Specialty Clinic/Center
  • Waseca, MN
  • NPI 1518494251
  NPD
• Sanford Health Network

  • Rural Health Clinic/Center
  • Mountain Lake, MN
  • NPI 1568469039
  NPD
• Sanford Clinic

  • Family Medicine Physician
  • Sioux Falls, SD
  • NPI 1255353934

  Physician Assistant

  NPD
• Sanford Clinic

  • Diagnostic Radiology Physician
  • Fargo, ND
  • NPI 1306641345
  NPD
• Sanford Health Network

  • Pediatrics Physician
  • Aberdeen, SD
  • NPI 1760676886
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Mayo Clinic Health System-Fairmont

  • General Acute Care Hospital
  • Fairmont, MN
  • NPI 1821066499

  Hospital

  Care Compare affiliation
• Mayo Clinic Health System-Southwest Minnesota Region

  • Critical Access Hospital
  • New Prague, MN
  • NPI 1124035282

  Hospital

  Care Compare affiliation
• Mayo Clinic Health System-Southwest Minnesota Region

  • General Acute Care Hospital
  • Mankato, MN
  • NPI 1154302487

  Hospital

  Care Compare affiliation
• Minnesota Valley Health Center Inc

  • Critical Access Hospital
  • Le Sueur, MN
  • NPI 1730248907

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1632873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730419200000",
    "number": "1144992132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 2ND ST NE",
            "city": "NEW PRAGUE",
            "state": "MN",
            "postal_code": "560711709",
            "telephone_number": "952-758-4431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 2ND ST NE",
            "city": "NEW PRAGUE",
            "state": "MN",
            "postal_code": "560711709",
            "telephone_number": "952-758-4431"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1210 W 18th Street",
            "address_2": "Suite G01",
            "address_purpose": "LOCATION",
            "city": "Sioux Falls",
            "state": "SD",
            "postal_code": "57104",
            "country_code": "US",
            "telephone_number": "605-328-2663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASBERG",
        "first_name": "MCKENZIE",
        "middle_name": "RAE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-29",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "13844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mneisen1771967@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "301 2nd St NE",
            "city": "New Prague",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560711709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MCKENZIE",
            "last_name": "NEISEN",
            "middle_name": "RAE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mala Strana Alf LLC
• Mala Strana Assisted Living
• Mala Strana Health Care LLC
• Foram Ashwin Mankodi, MBBS
• John Conrad Masberg, PT
• Mayo Clinic Health System-Southwest Minnesota Region
• Mayo Clinic Health System-Southwest Minnesota Region
• Mayo Clinic Health System-Southwest Minnesota Region
• Mayo Clinic Health System-Southwest Minnesota Region
• Jennifer Ann McDonald

• All providers in New Prague, MN
• Physician Assistant in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.