Active NPI
Mackenzie D. Nash, PA-S
- Physician Assistant
- El Dorado Hills, CA
National Provider Identifier
1275353559
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA67239
- Practice address
- 4031 Corralitas LN
El Dorado Hills, CA 95762-5076 - Phone
- (530) 410-4137
- NPI assigned
- Oct 11, 2024
- Last updated
- Apr 1, 2026
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA67239 | CA | Primary |
Addresses
Primary practice location
4031 Corralitas LN
El Dorado Hills, CA 95762-5076
Mailing address
10925 Old Oregon TRL
Redding, CA 96003-8243
Phone (530) 410-4137
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- University of California, Davis School of Medicine, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2550 Sister Mary Columba Dr
Red Bluff, CA 96080-4327
Phone 53052980000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA67239 | CA | MD | Physician Assistant |
Organizations & group practices 1
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": "1728604800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775001600000",
"number": "1275353559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10925 OLD OREGON TRL",
"city": "REDDING",
"state": "CA",
"postal_code": "960038243",
"telephone_number": "530-410-4137"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4031 CORRALITAS LN",
"city": "EL DORADO HILLS",
"state": "CA",
"postal_code": "957625076",
"telephone_number": "530-410-4137"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NASH",
"first_name": "MACKENZIE",
"middle_name": "D.",
"credential": "PA-S",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-10-11",
"last_updated": "2026-04-01",
"certification_date": "2026-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA67239",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Dorado Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.
- 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.