Mackenzy Lee Kassab, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601011399 Issued in MI

Practice address

31393 W 13 Mile Rd Ste 105
Farmington Hills, MI 48334-2232

Phone

(734) 331-6037

NPI assigned

Aug 8, 2022

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Jajo and Jonna Psychiatry PLLCGroup PAC ID 3971996638, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Jajo & Jonna Psychiatry PLLC

  • Psychiatry Physician
  • Farmington Hills, MI
  • NPI 1275205270
  Medicare reassignment Care Compare group
• Medcare Urgent Care PLLC

  • Urgent Care Clinic/Center
  • Redford, MI
  • NPI 1861971384
  Medicare reassignment

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

{
    "created_epoch": "1659916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1619605722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4421 FOREST HILL DR",
            "city": "COMMERCE TOWNSHIP",
            "state": "MI",
            "postal_code": "483821591",
            "telephone_number": "248-412-3120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31393 W 13 MILE RD STE 105",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483342232",
            "telephone_number": "734-331-6037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KASSAB",
        "first_name": "MACKENZY",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-08",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601011399",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MI PHYSICIAN ASSISTANT LICENSE",
            "identifier": "5601011399",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amelia Kasmikha, DDS
• Allison Kasongo
• Cameron Kaspari
• Mustafa Cuneyt Kasranoglu, MA
• Alem Kassa
• Ali Kassem
• Hassan Kassem, MD, MBA
• Myah Kassem
• Mallak Kassir
• Shari Kasten

• Physician Assistant in Farmington Hills, MI
• Providers in Farmington Hills, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2025; 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.