Individual provider Active NPI

Mackenzie Koven Quinn, AUDIOLOGIST

  • Audiologist
  • Sacramento, CA
National Provider Identifier
1164159810
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
3700 Issued in CA
Practice address
2521 Stockton Blvd
Sacramento, CA 95817-2207
Phone
(916) 734-2801
NPI assigned
Aug 3, 2022
Last updated
Aug 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 3700 CA Primary
Audiologist-Hearing Aid Fitter 237600000X 8783 CA

Addresses

Primary practice location

2521 Stockton Blvd
Sacramento, CA 95817-2207

Mailing address

8375 Dover Dr
Granite Bay, CA 95746-6267
Phone (916) 622-1645

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220922003427 CA Practitioner - Qualified Audiologist 1254716541 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Qualified Audiologist
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

550 W Ranch View Dr
Rocklin, CA 95765-5396
Phone (916) 295-5766

Merit-based Incentive Payment System (MIPS)

Final score
90.11 of 100Reported as group
Quality
86.24
Promoting interoperability
100
Improvement activities
40
Cost
78.35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8783CAMDAudiologist-Hearing Aid Fitter
3700CAMDClinical Nurse Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the Univ of Ca Current Accepting new patients
Regents of the University of California CurrentSince Aug 15, 2022 Accepting new patients
Regents of the Univ of Ca CurrentSince Aug 15, 2022 Accepting new patients
Regents of the University of California Current Accepting new patients
Regents of the Univ of Ca CurrentSince Aug 15, 2022 Accepting new patients
Regents of the University of California CurrentSince Aug 15, 2022 Accepting new patients
Essent PRMC LP Past Accepting new patients
Regents of the Univ of Ca Past Accepting new patients

Locations

550 W Ranch View Dr
Rocklin, CA 95765
Phone (916) 295-5700

2400 Del Paso Rd
Ste 145
Sacramento, CA 95834
Phone (916) 928-3940

2521 Stockton Blvd
Sacramento, CA 95817
Phone (916) 734-1104

2521 Stockton Blvd
Ste 5200
Sacramento, CA 95817
Phone (916) 734-2801

4900 Broadway
Ste 1200
Sacramento, CA 95820
Phone (916) 734-9255

500 University Ave
Ste 220
Sacramento, CA 95825
Phone (916) 286-8700

Organizations & group practices 8

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

NPI Registry JSON

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

{
    "created_epoch": "1659484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1164159810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8375 DOVER DR",
            "city": "GRANITE BAY",
            "state": "CA",
            "postal_code": "957466267",
            "telephone_number": "916-622-1645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2521 STOCKTON BLVD",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958172207",
            "telephone_number": "916-734-2801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINN",
        "first_name": "MACKENZIE",
        "middle_name": "KOVEN",
        "credential": "AUDIOLOGIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-03",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CA",
            "license": "3700",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "CA",
            "license": "8783",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.