Individual provider Active NPI

Mackenzie Decarlo

  • Psychiatric/Mental Health Nurse Practitioner
  • Hornell, NY
National Provider Identifier
1366158651
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
406633 Issued in NY
Practice address
7309 Seneca Rd N
Hornell, NY 14843-9691
Phone
(607) 282-5200
NPI assigned
Jan 30, 2023
Last updated
Jul 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 406633 NY Primary
Registered Nurse 163W00000X 710902 NY

Addresses

Primary practice location

7309 Seneca Rd N
Hornell, NY 14843-9691

Mailing address

7309 Seneca Rd N
Hornell, NY 14843-9691
Phone (607) 282-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20251113002289 NY Practitioner - Nurse Practitioner 1456842855 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Casa-Trinity IncGroup PAC ID 8527448000, 10 clinicians

Practice addresses (Care Compare)

4612 Millennium Dr
Geneseo, NY 14454-1197
Phone (585) 991-5012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
710902NYMDRegistered Nurse
406633NYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Casa-Trinity, Inc. CurrentSince Oct 6, 2025 Accepting new patients

Locations

244 W Water St
Ste 200
Elmira, NY 14901
Phone (607) 737-5215

4612 Millennium Dr
Geneseo, NY 14454
Phone (585) 443-2018

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": "1675036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1366158651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7309 SENECA RD N",
            "city": "HORNELL",
            "state": "NY",
            "postal_code": "148439691",
            "telephone_number": "607-282-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7309 SENECA RD N",
            "city": "HORNELL",
            "state": "NY",
            "postal_code": "148439691",
            "telephone_number": "607-282-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECARLO",
        "first_name": "MACKENZIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-30",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NY",
            "license": "406633",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "710902",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hornell, NY

Sources for this page

Verify at the official NPI Registry.