Individual provider Active NPI

Mackenzie Lily Reing, PA-C

  • Physician Assistant
  • Apple Valley, MN
National Provider Identifier
1598479628
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
14332 Issued in MN
Practice address
14655 Galaxie Ave
Apple Valley, MN 55124-8602
Phone
(651) 241-3779
Fax
(651) 241-3825
NPI assigned
Jan 12, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

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
Physician Assistant 363A00000X 14332 MN Primary

Addresses

Primary practice location

14655 Galaxie Ave
Apple Valley, MN 55124-8602

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 262-9000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mreing568859@excellian.direct.allina.com Direct

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
I20230406001265 MN Practitioner - Physician Assistant 0547635443 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allina Health SystemGroup PAC ID 4587573613, 3,844 clinicians

Practice addresses (Care Compare)

14655 Galaxie Ave
Apple Valley, MN 55124-8602
Phone (651) 241-3779

18465 Orchard TRL
Lakeville, MN 55044-8885
Phone (952) 428-0950

1880 N Frontage Rd
Hastings, MN 55033-2687
Phone (612) 775-6200

3270 W Lake St
Minneapolis, MN 55416-4512
Phone (612) 775-1800

440 Elm St E
Annandale, MN 55302-1109
Phone (320) 682-5225

6350 W 143Rd St
Savage, MN 55378-2890

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
94.23
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14332MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Allina Health System CurrentSince Mar 3, 2025 Accepting new patients
Emergency Physicians Professional Association CurrentSince May 1, 2023 Accepting new patients
Emergency Physicians Professional Association CurrentSince May 1, 2023 Accepting new patients
Allina Health System CurrentSince Mar 3, 2025 Accepting new patients
Allina Health System Past Accepting new patients

Locations

440 Elm St E
Annandale, MN 55302
Phone (320) 682-5225

11269 Jefferson Hwy N
Champlin, MN 55316
Phone (763) 236-0600

4300 Marketpointe Dr
Ste 100
Minneapolis, MN 55435
Phone (952) 767-4574

2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

14655 Galaxie Ave
Saint Paul, MN 55124
Phone (952) 432-4141

8675 Valley Creek Rd
Woodbury, MN 55125
Phone (651) 241-3000

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": "1673481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743638400000",
    "number": "1598479628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-262-9000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14655 GALAXIE AVE",
            "city": "APPLE VALLEY",
            "state": "MN",
            "postal_code": "551248602",
            "telephone_number": "651-241-3779",
            "fax_number": "651-241-3825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REING",
        "first_name": "MACKENZIE",
        "middle_name": "LILY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-12",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MN",
            "license": "14332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mreing568859@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "14655 Galaxie Ave",
            "city": "Apple Valley",
            "state": "MN",
            "country_code": "US",
            "postal_code": "551248602",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Apple Valley, MN

Sources for this page

Verify at the official NPI Registry.