Individual provider Active NPI

Mackenzie Jeanne Van Rees, PA

  • Physician Assistant
  • Hiawatha, IA
National Provider Identifier
1336640366
Registry record updated Jun 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
092632 Issued in IA
Practice address
1940 Blairs Ferry Rd Ste 104
Hiawatha, IA 52233-2076
Phone
(193) 393-0178
NPI assigned
Feb 25, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 092632 IA Primary

Addresses

Primary practice location

1940 Blairs Ferry Rd Ste 104
Hiawatha, IA 52233-2076

Mailing address

1940 Blairs Ferry Rd Ste 104
Hiawatha, IA 52233-2076
Phone (193) 393-0178

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20180720001804 IA Practitioner - Physician Assistant 7416204557 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iowa Physicians Clinic Medical FoundationGroup PAC ID 8729992318, 1,254 clinicians

Practice addresses (Care Compare)

153 Collins Rd NE
Unity Point Express
Cedar Rapids, IA 52402-3201
Phone (319) 826-2972

4480 Utica Ridge Rd
Bettendorf, IA 52722-1644

4480 Utica Ridge Rd
Suite 160
Bettendorf, IA 52722-1637
Phone (563) 742-5950

Hospital & facility affiliations

  • St Lukes Hospital Hospital, Cedar Rapids, IA, CCN 160045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
092632IAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa Physicians Clinic Medical Foundation CurrentSince Nov 22, 2021 Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients
Allen Memorial Hospital Corporation Physician Assistant CurrentSince Aug 5, 2018 Accepting new patients
Iowa Physicians Clinic Medical Foundation Physician Assistant CurrentSince Nov 22, 2021 Accepting new patients
Unitypoint Health - Marshalltown CurrentSince Jul 5, 2018 Accepting new patients
Salahuddin Syed MD PC Current Accepting new patients

Locations

4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950

4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150

1026 A Ave NE
Cedar Rapids, IA 52402
Phone (319) 369-5970

1200 Pleasant St
Des Moines, IA 50309
Phone (515) 241-5926

1940 Blairs Ferry Rd
Ste 104
Hiawatha, IA 52233
Phone (319) 393-0178

55 Unitypoint Way
Marshalltown, IA 50158
Phone (641) 754-5145

3 S 4th Ave
Marshalltown, IA 50158
Phone (641) 754-5145

1825 Logan Ave
Waterloo, IA 50703
Phone (319) 235-3886

Interoperability endpoints

  • Direct secure messaging: mstueck259230@direct.unitypoint.org

Organizations & group practices 9

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1519516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687478400000",
    "number": "1336640366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1940 BLAIRS FERRY RD STE 104",
            "city": "HIAWATHA",
            "state": "IA",
            "postal_code": "522332076",
            "telephone_number": "193-393-0178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1940 BLAIRS FERRY RD STE 104",
            "city": "HIAWATHA",
            "state": "IA",
            "postal_code": "522332076",
            "telephone_number": "193-393-0178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN REES",
        "first_name": "MACKENZIE",
        "middle_name": "JEANNE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-25",
        "last_updated": "2023-06-23",
        "certification_date": "2023-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "092632",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hiawatha, IA

Sources for this page

Verify at the official NPI Registry.