Mackenzie Rose Betz, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10002980A Issued in IN

Practice address

721 W 13TH St Ste 321
Jasper, IN 47546-1857

Phone

(812) 996-7918

NPI assigned

Jun 17, 2020

Last updated

Dec 10, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mbetz1043731@direct.deaconess.com

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.

• Deaconess Clinic Inc.

  • Internal Medicine Physician
  • Evansville, IN
  • NPI 1619123585
  Medicare reassignment
• Deaconess Memorial Medical Center Inc

  dba Memorial Healthcare of Huntingburg

  • Emergency Medicine Physician
  • Huntingburg, IN
  • NPI 1114120128
  Medicare reassignment
• Deaconess Memorial Medical Center Inc

  dba Memorial Hospital and Health Care Center

  • Family Medicine Physician
  • Holland, IN
  • NPI 1255525721
  NPD
• Deaconess Memorial Medical Center Inc

  dba Deaconess Comprehensive Pain Management - Jasper

  • Pain Medicine Physician
  • Jasper, IN
  • NPI 1457164543
  NPD
• Deaconess Memorial Medical Center Inc

  dba Memorial Hospital and HealthCare Center

  • Hospitalist Physician
  • Jasper, IN
  • NPI 1588778518

  Physician Assistant

  NPD
• Deaconess Clinic, Inc

  dba Deaconess Clinic I

  • Rural Health Clinic/Center
  • Princeton, IN
  • NPI 1528214400
  NPD (past)
• Deaconess Memorial Medical Center Inc

  dba Memorial Hospital and Health Care Center Neurology

  • Pulmonary Disease Physician
  • Jasper, IN
  • NPI 1326123910
  NPD (past)

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

{
    "created_epoch": "1592352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1235755190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1028",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475471028",
            "telephone_number": "812-996-8478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 W 13TH ST STE 321",
            "city": "JASPER",
            "state": "IN",
            "postal_code": "475461857",
            "telephone_number": "812-996-7918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETZ",
        "first_name": "MACKENZIE",
        "middle_name": "ROSE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-17",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10002980A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory Alan Berger, DDS
• Leeann Berger, AUD
• Sydney Berger, DC
• Billy Lee Berry, MARRIAGE FAMILY THER
• Jordan Berry, PHARMD
• Astha Bhardwaj, MD
• Brenda Jean Bielawa
• Douglas A Bies, MD
• Alyssa Marie Blair, OTR
• Ashli Beth Blankenship Clark, MS, OTR

• Physician Assistant in Jasper, IN
• Providers in Jasper, IN by specialty
• Physician Assistant in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; 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.

Verify at the official NPI Registry.