Individual provider Active NPI

McKenzie Mae Cooper

  • Medical Physician Assistant
  • Marshalltown, IA
National Provider Identifier
1487150991
Registry record updated Apr 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
090944 Issued in IA
Practice address
3 S 4TH Ave
Marshalltown, IA 50158-2924
Phone
(515) 326-0385
NPI assigned
Apr 3, 2018
Last updated
Apr 3, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 090944 IA Primary

Addresses

Primary practice location

3 S 4TH Ave
Marshalltown, IA 50158-2924

Mailing address

7071 Carey CT
Johnston, IA 50131-2407
Phone (515) 326-0385

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
I20180608002142 IA Practitioner - Physician Assistant 2668727983 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
81.6 of 100Reported as group
Quality
83.66
Promoting interoperability
83
Improvement activities
40
Cost
69.17

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Salahuddin Syed MD PC Current Accepting new patients
St Luke's Methodist Hospital Current Accepting new patients
Unitypoint Health - Marshalltown CurrentSince May 23, 2018 Accepting new patients
Unitypoint Health - Marshalltown CurrentSince May 23, 2018 Accepting new patients
Allen Memorial Hospital Corporation CurrentSince May 29, 2018 Accepting new patients

Locations

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

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

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

Interoperability endpoints

  • Direct secure messaging: mcooper17109@direct.unitypoint.org

Organizations & group practices 6

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": "1522713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522713600000",
    "number": "1487150991",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7071 CAREY CT",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501312407",
            "telephone_number": "515-326-0385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 S 4TH AVE",
            "city": "MARSHALLTOWN",
            "state": "IA",
            "postal_code": "501582924",
            "telephone_number": "515-326-0385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COOPER",
        "first_name": "MCKENZIE",
        "middle_name": "MAE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-03",
        "last_updated": "2018-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IA",
            "license": "090944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshalltown, IA

Sources for this page

Verify at the official NPI Registry.