Individual provider Active NPI

Mackenzie Jo Ela, PA-C

  • Physician Assistant
  • Marietta, OH
National Provider Identifier
1609628197
Registry record updated Apr 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
217 Ingleside Ave Apt a
Marietta, OH 45750-3477
Phone
(503) 410-9499
NPI assigned
Apr 5, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

217 Ingleside Ave Apt a
Marietta, OH 45750-3477

Mailing address

217 Ingleside Ave Apt a
Marietta, OH 45750-3477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20241018001278 OH Practitioner - Physician Assistant 0244762987 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

158 W Main Rd
Conneaut, OH 44030-2039

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
University Primary Care Practices Inc CurrentSince Sep 9, 2024 Accepting new patients
University Primary Care Practices Inc CurrentSince Sep 9, 2024 Accepting new patients
Multicare Health System Physician Assistant Past Accepting new patients
University Primary Care Practices Past Accepting new patients
University Hospitals Medical Group Inc Past Accepting new patients

Locations

158 W Main Rd
Ste 203
Conneaut, OH 44030
Phone (440) 285-2960

Interoperability endpoints

  • Direct secure messaging: mela594217@ehrdirect.uhhospitals.org

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1712275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712275200000",
    "number": "1609628197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "217 INGLESIDE AVE APT A",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457503477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "217 INGLESIDE AVE APT A",
            "city": "MARIETTA",
            "state": "OH",
            "postal_code": "457503477",
            "telephone_number": "503-410-9499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELA",
        "first_name": "MACKENZIE",
        "middle_name": "JO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-05",
        "last_updated": "2024-04-05",
        "certification_date": "2024-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, OH

Sources for this page

Verify at the official NPI Registry.