Mackayla Renee Probasco, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

25MP00550100 Issued in NJ

Practice address

911 Sunset Rd
Burlington, NJ 08016-2250

Phone

(609) 387-8787

NPI assigned

Oct 24, 2019

Sex

Female

Sole proprietor

No

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 NJ

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

Specialty

Physician Assistant

Education

Other

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Browne Medical LLCGroup PAC ID 9032347281, 19 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Browne Medical, LLC

  • Urgent Care Clinic/Center
  • South Plainfield, NJ
  • NPI 1851733349
  Medicare reassignment Care Compare group
• The Radiology Group of New Jersey, LLC

  • Multi-Specialty Clinic/Center
  • Hackettstown, NJ
  • NPI 1174010540
  NPD (past)

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

{
    "created_epoch": "1571875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1568005387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53 IVINS DR",
            "city": "NEW EGYPT",
            "state": "NJ",
            "postal_code": "085332810",
            "telephone_number": "732-644-4029"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 SUNSET RD",
            "city": "BURLINGTON",
            "state": "NJ",
            "postal_code": "080162250",
            "telephone_number": "609-387-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROBASCO",
        "first_name": "MACKAYLA",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-24",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00550100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elvita G Pipiton, R.N.
• Carol Lynn Prague, RN
• Kimberly Pratola, LPN
• Prince Association for the Developmentally Disabled, Inc
• Annalise Pritchett, PT, DPT, OCS
• Debbra Prosperi, LPN
• Anthony Prousi, DDS, MD
• Michele Renee Pryor-Andrews, LPN
• Anna Pukajlo-Kwasniewska, PT
• Purpose Human Services

• Medical Physician Assistant in Burlington, NJ
• Providers in Burlington, NJ by specialty
• Medical Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; 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.

Verify at the official NPI Registry.