Mackenzie Mae Smith

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11287-33 Issued in WI

Practice address

2124 Kohler Memorial Dr Ste 110
Sheboygan, WI 53081-3174

Phone

(833) 821-7246

NPI assigned

Sep 8, 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

• Mackenzie Walesh Former name

Medicare fee-for-service enrollment

Enrolled in WI

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

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Progressive Beginnings, LLCGroup PAC ID 7012189848, 19 clinicians

Wisconsin Spine and Pain SCGroup PAC ID 0345665469, 19 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Nicholas Hospital Hospital, Sheboygan, WI, CCN 520044

Merit-based Incentive Payment System (MIPS)

Final score

89.02 of 100Reported as group

Quality

82.89

Improvement activities

40

Cost

74.29

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Wisconsin Spine and Pain SC

  • Interventional Pain Medicine Physician
  • Sheboygan, WI
  • NPI 1790309276
  Medicare reassignment Care Compare group NPD
• Progressive Beginnings, LLC

  • Rehabilitation Clinic/Center
  • Sheboygan, WI
  • NPI 1598886152
  Care Compare group
• Wisconsin Spine and Pain SC

  • Durable Medical Equipment & Medical Supplies
  • Appleton, WI
  • NPI 1285452391
  NPD

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

• St Nicholas Hospital-Sisters of the Third Order of St. Francis

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Sheboygan, WI
  • NPI 1427009992

  Hospital

  Care Compare affiliation
• St. Nicholas Hospital-Sisters of the Third Order of St Francis

  • General Acute Care Hospital
  • Sheboygan, WI
  • NPI 1730184342
  Care Compare affiliation

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

{
    "created_epoch": "1631059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688601600000",
    "number": "1306515804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 HURON ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542202932",
            "telephone_number": "920-905-1236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 KOHLER MEMORIAL DR STE 110",
            "city": "SHEBOYGAN",
            "state": "WI",
            "postal_code": "530813174",
            "telephone_number": "833-821-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MACKENZIE",
        "middle_name": "MAE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-08",
        "last_updated": "2023-07-06",
        "certification_date": "2023-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WI",
            "license": "11287-33",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MACKENZIE",
            "last_name": "WALESH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Ninnapa Slezak, PHARMD
• Noah T Slife, PA
• Laura R Slykhouse, MD
• Smiling Dog Investments Inc
• Edward Lawrence Smith, D.O.
• Rachel E Smith, DC
• Sarah Jeane Smith, M.D.
• Beth Sobczak III, PT
• Samuel K Soda, OD
• Ekaterina V Soforo, M.D.

• Family Nurse Practitioner in Sheboygan, WI
• Providers in Sheboygan, WI by specialty
• Family Nurse Practitioner in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2023; 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.