Individual provider Active NPI

Mackenzie Young

  • Family Nurse Practitioner
  • Williamsville, NY
National Provider Identifier
1437619301
Registry record updated Jan 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
343956 Issued in NY
Practice address
45 Spindrift Dr
Williamsville, NY 14221-7889
Phone
(716) 422-5422
Fax
(716) 422-5420
NPI assigned
Mar 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 343956 NY Primary

Addresses

Primary practice location

45 Spindrift Dr
Williamsville, NY 14221-7889

Mailing address

45 Spindrift Dr
Williamsville, NY 14221-7889
Phone (716) 422-5422

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
I20190417001486 NY Practitioner - Nurse Practitioner 5597006692 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
General Physician PCGroup PAC ID 9537213079, 488 clinicians

Practice addresses (Care Compare)

45 Spindrift Dr
Suite 100
Williamsville, NY 14221-7889
Phone (716) 422-5422

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
343956NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
General Physician, PC CurrentSince Jun 1, 2019 Accepting new patients

Locations

100 High St
#B2
Buffalo, NY 14203
Phone (716) 859-1256

3898 Vineyard Dr
Dunkirk, NY 14048
Phone (716) 363-1515

5844 Southwestern Blvd
Ste 500
Hamburg, NY 14075
Phone (716) 626-4200

45 Spindrift Dr
Williamsville, NY 14221
Phone (716) 422-5422

45 Spindrift Dr
Ste 100
Williamsville, NY 14221
Phone (716) 422-5422

Interoperability endpoints

  • Direct secure messaging: mmcmahon@gppc.medentdirect.com

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578528000000",
    "number": "1437619301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 SPINDRIFT DR",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142217889",
            "telephone_number": "716-422-5422",
            "fax_number": "716-422-5420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 SPINDRIFT DR",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142217889",
            "telephone_number": "716-422-5422",
            "fax_number": "716-422-5420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "MACKENZIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-25",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "343956",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Williamsville, NY

Sources for this page

Verify at the official NPI Registry.