Individual provider Active NPI

Mackenzie Young, PA-C

  • Physician Assistant
  • St Johnsbury, VT
National Provider Identifier
1689485914
Registry record updated Apr 7, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
055.0031816 Issued in VT
Practice address
165 Sherman Dr
Saint Johnsbury, VT 05819-9811
Phone
(802) 748-9405
NPI assigned
Jan 16, 2025
Last updated
Apr 7, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2026

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 055.0031816 VT Primary

Addresses

Primary practice location

165 Sherman Dr
Saint Johnsbury, VT 05819-9811

Mailing address

185 Sherman Dr
St Johnsbury, VT 05819-9811
Phone (802) 748-5041

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VT
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
I20250624000427 VT Practitioner - Physician Assistant 5092227330 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

165 Sherman Dr
Saint Johnsbury, VT 05819-9811

185 Sherman Dr
Saint Johnsbury, VT 05819-9811
Phone (802) 748-5041

26 Cedar LN
Danville, VT 05828-9751
Phone (802) 684-2275

457 Railroad St
Suite 2
Saint Johnsbury, VT 05819-1643
Phone 80274894051599

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northern Counties Health Care, Inc. CurrentSince Aug 4, 2025 Accepting new patients
Northern Counties Health Care Inc CurrentSince Aug 4, 2025 Accepting new patients
Northern Counties Health Care Past Accepting new patients

Locations

26 Cedar Ln
Danville, VT 05828
Phone (802) 684-2275

137 Main St
Ste 102
Newport, VT 05855
Phone (802) 995-2412

165 Sherman Dr
St Johnsbury, VT 05819
Phone (802) 748-9405

185 Sherman Dr
St Johnsbury, VT 05819
Phone (802) 695-2512

457 Railroad St
#2
St Johnsbury, VT 05819
Phone (802) 633-6351

Interoperability endpoints

  • Direct secure messaging: mackenzie.young.1@28542.direct.athenahealth.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1736985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775520000000",
    "number": "1689485914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 SHERMAN DR",
            "city": "ST JOHNSBURY",
            "state": "VT",
            "postal_code": "058199811",
            "telephone_number": "802-748-5041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 SHERMAN DR",
            "city": "SAINT JOHNSBURY",
            "state": "VT",
            "postal_code": "058199811",
            "telephone_number": "802-748-9405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNG",
        "first_name": "MACKENZIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-16",
        "last_updated": "2026-04-07",
        "certification_date": "2026-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "VT",
            "license": "055.0031816",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St Johnsbury, VT

Sources for this page

Verify at the official NPI Registry.