NPIMap

Individual provider Active NPI

Mackenzie George, PA-C

  • Medical Physician Assistant
  • Kalispell, MT
National Provider Identifier
1750826061
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MG4077079 Issued in MT
Practice address
175 Commons Loop Ste 300
Kalispell, MT 59901-1904
Phone
(406) 756-7555
NPI assigned
Dec 21, 2016
Last updated
Mar 15, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MG4077079 MT Primary

Addresses

Primary practice location

175 Commons Loop Ste 300
Kalispell, MT 59901-1904

Mailing address

175 Commons Loop Ste 300
Kalispell, MT 59901-1904
Phone (406) 756-7555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20170215001417 MT Practitioner - Physician Assistant 9931482080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Associates PLLPGroup PAC ID 5193617223, 9 clinicians

Practice addresses (Care Compare)

175 Commons Loop
Suite 300
Kalispell, MT 59901-1904
Phone (406) 755-7555

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.95 of 100Reported as individual
Quality
85.89
Improvement activities
40

National Provider Directory

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

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 8

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": "1482278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1750826061",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 COMMONS LOOP STE 300",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599011904",
            "telephone_number": "406-756-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 COMMONS LOOP STE 300",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599011904",
            "telephone_number": "406-756-7555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEORGE",
        "first_name": "MACKENZIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-21",
        "last_updated": "2021-03-15",
        "certification_date": "2021-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MT",
            "license": "MG4077079",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kalispell, MT

Sources for this page

Verify at the official NPI Registry.