Active NPI
Mackenzie Tatar, PA
- Physician Assistant
- Boston, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA9164
- Practice address
- 725 Albany St Ste 4B
Boston, MA 02118-3549 - Phone
- (617) 638-5633
- Fax
- (617) 414-5226
- NPI assigned
- Nov 8, 2022
- Sex
- Female
- Sole proprietor
- No
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 | PA9164 | MA | Primary |
Addresses
Primary practice location
725 Albany St Ste 4B
Boston, MA 02118-3549
Mailing address
960 Massachusetts Ave
FL 2
Boston, MA 02118
Other practice location 1
39B District Ave
Dorchester, MA 02125-1683
Phone (617) 638-7869
Other names 1
- Mackenzie Bonner
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VT, MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2022
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1 Boston Medical Ctr PL
Boston, MA 02118-2908
Phone (617) 638-5633
110 Liberty St
Brockton, MA 02301-5521
Phone (508) 894-0400
680 Centre St
Brockton, MA 02302-3308
Phone (508) 941-7000
725 Albany St
Boston, MA 02118-2526
Phone (617) 638-5633
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA9164 | MA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boston University Orthopaedic Surgical Associates, Inc. | Current | Accepting new patients | |
| Boston University Family Medicine, Inc. | Past | Accepting new patients |
Locations
725 Albany St
Boston, MA 02118
Phone (617) 414-4075
725 Albany St
Ste 4B
Boston, MA 02118
Phone (617) 638-5633
960 Massachusetts Ave
Ste 2
Boston, MA 02118
39B District Ave
Dorchester, MA 02125
Phone (617) 638-7869
Interoperability endpoints
- mbonner447978@direct.bilh.masshiway.net
- mackenzie.bonner@direct.signature.masshiway.net
Organizations & group practices 3
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.
-
- Orthopaedic Surgery Physician
- Boston, MA
- NPI 1164460580
-
- Internal Medicine Physician
- Brockton, MA
- NPI 1508804949
-
- Family Medicine Physician
- Boston, MA
- NPI 1134166390
Hospital & facility affiliations 9
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Boston, MA
- NPI 1164177028
-
- Community Health Clinic/Center
- South Boston, MA
- NPI 1225228679
Hospital
-
- General Acute Care Hospital
- Boston, MA
- NPI 1346218294
-
- Community Health Clinic/Center
- Roslindale, MA
- NPI 1386718823
Hospital
-
- Community Health Clinic/Center
- Dorchester, MA
- NPI 1780874677
Hospital
-
- Community Health Clinic/Center
- East Boston, MA
- NPI 1861683518
Hospital
-
- General Acute Care Hospital
- Brockton, MA
- NPI 1063431286
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1667865600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1771459200000",
"number": "1457069494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "960 MASSACHUSETTS AVE",
"address_2": "FL 2",
"city": "BOSTON",
"state": "MA",
"postal_code": "02118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 ALBANY ST STE 4B",
"city": "BOSTON",
"state": "MA",
"postal_code": "021183549",
"telephone_number": "617-638-5633",
"fax_number": "617-414-5226"
}
],
"practiceLocations": [
{
"address_1": "39B District Ave",
"address_purpose": "LOCATION",
"city": "Dorchester",
"state": "MA",
"postal_code": "021251683",
"country_code": "US",
"telephone_number": "617-638-7869",
"fax_number": "617-638-7769",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TATAR",
"first_name": "MACKENZIE",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-11-08",
"last_updated": "2026-02-19",
"certification_date": "2026-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MA",
"license": "PA9164",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MACKENZIE",
"last_name": "BONNER",
"credential": "PA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 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.