Andrew Mackinnon, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

MT231569 Issued in PA

Practice address

901 Walnut St FL 4
Philadelphia, PA 19107-5214

Phone

(215) 955-9425

Fax

(215) 503-2452

NPI assigned

Apr 8, 2024

Last updated

May 14, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1712534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1619720877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 WALNUT ST FL 4",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075214",
            "telephone_number": "215-955-9425",
            "fax_number": "215-503-2452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 WALNUT ST FL 4",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191075214",
            "telephone_number": "215-955-9425",
            "fax_number": "215-503-2452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKINNON",
        "first_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-04-08",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "MT231569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenna Mackenzie, M.S., CCC-SLP
• Raquel Patrice Mackenzie, CRNP
• Ann Mackey
• Brendan P. Mackey, MD
• Chase Mackey, DO
• Elisa Macklin, RPH
• Jarrod Macklin, R.PH
• Blake Macko, MSS
• Samantha Macko, PHARMD
• Lynn Mackovick, D.O.

• Neurology Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Neurology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.