Individual provider Active NPI

Mackenzie Lynn Sheetz, PHYSICIAN ASSISTANT

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1487362299
Registry record updated Jun 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
OA006323 Issued in PA
Practice address
1412 Fairmount Ave
Philadelphia, PA 19130-2908
Phone
(484) 706-2645
NPI assigned
Nov 10, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2026

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 MA064212 PA
Physician Assistant 363A00000X OA006323 PA Primary

Addresses

Primary practice location

1412 Fairmount Ave
Philadelphia, PA 19130-2908

Mailing address

1701 Wallace St Apt 1
Philadelphia, PA 19130-3314
Phone (484) 706-2645

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address sheetzm@dvch.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20221209000898 PA Practitioner - Physician Assistant 4284003443 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA064212PAMDFamily Medicine Physician
OA006323PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Delaware Valley Community Health, Inc. CurrentSince Nov 1, 2022 Accepting new patients
Delaware Valley Community Health, Inc. CurrentSince Nov 1, 2022 Accepting new patients

Locations

1412 Fairmount Ave
Philadelphia, PA 19130
Phone (215) 235-9600

Interoperability endpoints

  • Direct secure messaging: mackenzie.sheetz.p1@direct.dvch.nextgenshare.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1668038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781222400000",
    "number": "1487362299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 WALLACE ST APT 1",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191303314",
            "telephone_number": "484-706-2645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 FAIRMOUNT AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191302908",
            "telephone_number": "484-706-2645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEETZ",
        "first_name": "MACKENZIE",
        "middle_name": "LYNN",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-10",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA064212",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "OA006323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sheetzm@dvch.org",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1412 Fairmount Ave",
            "city": "Philadelphia",
            "state": "PA",
            "country_code": "US",
            "postal_code": "191302908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.