Individual provider Active NPI

Mackenzie Noesen, CNP

  • Nurse Practitioner
  • Woodbury, MN
National Provider Identifier
1558975680
Registry record updated Sep 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
8774 Issued in MN
Practice address
1000 Radio Dr Ste 120
Woodbury, MN 55125-8410
Phone
(651) 496-6865
Fax
(651) 495-6893
NPI assigned
Sep 5, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 8774 MN Primary

Addresses

Primary practice location

1000 Radio Dr Ste 120
Woodbury, MN 55125-8410

Mailing address

8170 33Rd Ave S # Ms 21110Q
Minneapolis, MN 55425-4516

Other names 1

  • Mackenzie Yaggie Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20220221001545 MN Practitioner - Nurse Practitioner 6103225990 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Group Health IncGroup PAC ID 1759293954, 1,627 clinicians

Practice addresses (Care Compare)

15350 English Ave
Apple Valley, MN 55124-6252
Phone (952) 431-8500

401 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 254-7400

435 Phalen Blvd
Saint Paul, MN 55130-5302
Phone (651) 291-2848

8325 Seasons Pkwy
Woodbury, MN 55125-4402
Phone (651) 702-5868

8450 Seasons Pkwy
Woodbury, MN 55125-4402
Phone (651) 702-5300

8600 Nicollet Ave
Bloomington, MN 55420-2824
Phone (952) 884-1148

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
8774MNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Hennepin Healthcare System, Inc CurrentSince Apr 27, 2022 Accepting new patients
Group Health, Inc. CurrentSince Apr 4, 2022 Accepting new patients
Hennepin Healthcare System Inc CurrentSince Apr 27, 2022 Accepting new patients
Hennepin Healthcare System, Inc Current Accepting new patients
Group Health, Inc. Current Accepting new patients
Group Health, Inc. CurrentSince Apr 4, 2022 Accepting new patients

Locations

701 Park Ave
Minneapolis, MN 55415
Phone (612) 873-6005

2220 Riverside Ave
Minneapolis, MN 55454
Phone (612) 371-1600

8600 Nicollet Ave S
Minneapolis, MN 55420
Phone (952) 887-6600

8170 33rd Ave S
#21110Q
Minneapolis, MN 55425
Phone (952) 883-5375

401 Phalen Blvd
Saint Paul, MN 55130
Phone (651) 254-7870

8450 Seasons Pkwy
Woodbury, MN 55125
Phone (651) 702-5300

1000 Radio Dr
Ste 120
Woodbury, MN 55125
Phone (651) 495-6865

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1599264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788307200000",
    "number": "1558975680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8170 33RD AVE S # MS 21110Q",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554254516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 RADIO DR STE 120",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551258410",
            "telephone_number": "651-496-6865",
            "fax_number": "651-495-6893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOESEN",
        "first_name": "MACKENZIE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-05",
        "last_updated": "2026-09-02",
        "certification_date": "2026-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "8774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MACKENZIE",
            "last_name": "YAGGIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.