NPIMap

Individual provider Active NPI

Hannah Mackenzie

  • Physician Assistant
  • Broomfield, CO
National Provider Identifier
1720691652
Registry record updated Jul 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.0007580 Issued in CO
Practice address
403 Summit Blvd Unit 204
Broomfield, CO 80021-8253
Phone
(720) 401-2139
NPI assigned
Aug 29, 2020
Last updated
Jul 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2023

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 PA.0007580 CO Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

403 Summit Blvd Unit 204
Broomfield, CO 80021-8253

Mailing address

403 Summit Blvd Unit 204
Broomfield, CO 80021-8253
Phone (720) 401-2139

Other names 1

  • Hannah Reger Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221216000768 CO Practitioner - Physician Assistant 8426427238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
J Michael King MD PCGroup PAC ID 4183898877, 13 clinicians
Select Physical Therapy of West Denver Limited PartnershipGroup PAC ID 6709771157, shared by 5 NPIs, 530 clinicians

Practice addresses (Care Compare)

1030 Johnson Rd
Suite 350
Golden, CO 80401-6053
Phone (720) 401-2139

400 Indiana St
Suite 340
Golden, CO 80401-5033
Phone (720) 452-1267

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.08 of 100Reported as group
Quality
71.78
Promoting interoperability
100
Improvement activities
40
Cost
75.14

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.0007580COMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: hannah.reger.1@3333.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1598659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689292800000",
    "number": "1720691652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 SUMMIT BLVD UNIT 204",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800218253",
            "telephone_number": "720-401-2139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 SUMMIT BLVD UNIT 204",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800218253",
            "telephone_number": "720-401-2139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKENZIE",
        "first_name": "HANNAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-29",
        "last_updated": "2023-07-14",
        "certification_date": "2023-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0007580",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HANNAH",
            "last_name": "REGER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Broomfield, CO

Sources for this page

Verify at the official NPI Registry.