Mackenzie Eiseman, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

TC392 Issued in KY

Practice address

110 Conn Ter
Lexington, KY 40508-3206

Phone

(615) 429-8246

NPI assigned

Jul 27, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Shriners Hospitals for Children

  • Medical Specialty Clinic/Center
  • Lexington, KY
  • NPI 1801249925
  Medicare reassignment
• Shriners Hospitals for Children

  • Pediatric Orthopaedic Surgery Physician
  • Lexington, KY
  • NPI 1457808495

  Physician Assistant

  NPD
• Shriners Hospitals for Children

  dba Shriners Children's Hawaii

  • Clinic/Center
  • Aiea, HI
  • NPI 1568299857
  NPD
• Shriners Hospitals for Children

  • Orthopaedic Surgery Physician
  • Lexington, KY
  • NPI 1700223559
  NPD (past)

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

{
    "created_epoch": "1690416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690416000000",
    "number": "1518648104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1119 WOODRIDGE PL",
            "city": "MT JULIET",
            "state": "TN",
            "postal_code": "371224502",
            "telephone_number": "615-429-8246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 CONN TER",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405083206",
            "telephone_number": "615-429-8246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EISEMAN",
        "first_name": "MACKENZIE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-07-27",
        "last_updated": "2023-07-27",
        "certification_date": "2023-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "TC392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Harold Andrew Eichorst, DC
• Richard George Eickler, MD
• Steven Edwin Eilers, M.D.
• Janet Darlene Einbecker, CRNA
• Mark E Einbecker, MD
• Gabrielle Eismann
• Katherine Ekman
• Katrina Ekmann, RN
• Dalya A El Ghazy
• Elias El Haddad, MD

• Physician Assistant in Lexington, KY
• Providers in Lexington, KY by specialty
• Physician Assistant in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.