Individual provider Active NPI

Mackenzie Silva, PA-C

  • Physician Assistant
  • Renton, WA
National Provider Identifier
1760221774
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
61519223 Issued in WA
Practice address
604 Oakesdale Ave SW Ste 102
Renton, WA 98057-5204
Phone
(253) 327-7960
NPI assigned
May 20, 2024
Last updated
May 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 61519223 WA Primary

Addresses

Primary practice location

604 Oakesdale Ave SW Ste 102
Renton, WA 98057-5204

Mailing address

7480 Alpenridge PL SE
Port Orchard, WA 98367-9044
Phone (801) 592-6479

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20240806004416 WA Practitioner - Physician Assistant 5799222832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians

Practice addresses (Care Compare)

222 State Ave N
Kent, WA 98030-4544
Phone (253) 372-7788

311 S L St
Tacoma, WA 98405-3720

321 Ramsay Way
Suite 104
Kent, WA 98032-4544
Phone (253) 372-7960

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
61519223WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System CurrentSince Jul 15, 2024 Accepting new patients
Multicare Health System CurrentSince Jul 15, 2024 Accepting new patients
Multicare Health System Physician Assistant Past Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

311 S L St
Tacoma, WA 98405
Phone (253) 403-1444

Organizations & group practices 4

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 1

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": "1716163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716163200000",
    "number": "1760221774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7480 ALPENRIDGE PL SE",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983679044",
            "telephone_number": "801-592-6479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 OAKESDALE AVE SW STE 102",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980575204",
            "telephone_number": "253-327-7960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SILVA",
        "first_name": "MACKENZIE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-20",
        "last_updated": "2024-05-20",
        "certification_date": "2024-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "61519223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

Verify at the official NPI Registry.