Individual provider Active NPI

Mackenzie Bernu, MD

  • Family Medicine Physician
  • Saint Paul, MN
National Provider Identifier
1710731682
Registry record updated Apr 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
80684 Issued in MN
Practice address
580 Rice St
Saint Paul, MN 55103-2148
Phone
(651) 227-6551
NPI assigned
Apr 16, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 80684 MN Primary

Addresses

Primary practice location

580 Rice St
Saint Paul, MN 55103-2148

Mailing address

580 Rice St
Saint Paul, MN 55103-2148

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260423001783 MN Practitioner - Family Practice 8527502673 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Creighton University School of Medicine, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1700 University Ave W
Saint Paul, MN 55104-3727

2594 Alpine Dr
Woodbury, MN 55125-1914

580 Rice St
Saint Paul, MN 55103-2148

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
80684MNMDFamily Medicine Physician

Organizations & group practices 1

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": "1713225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776643200000",
    "number": "1710731682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "580 RICE ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551032148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "580 RICE ST",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551032148",
            "telephone_number": "651-227-6551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BERNU",
        "first_name": "MACKENZIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-16",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "80684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.