NPIMap

Individual provider Active NPI

Mackenzie Aleece Mady, D.O.

  • Family Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1760641328
Registry record updated Mar 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OS015038 Issued in PA
Practice address
100 South Juniper
3Rd Floor #8528
Philadelphia, PA 19107-1316
Phone
(617) 505-1520
Fax
(617) 928-8401
NPI assigned
Jun 8, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 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 OS015038 PA Primary

Addresses

Primary practice location

100 South Juniper
3Rd Floor #8528
Philadelphia, PA 19107-1316

Mailing address

109 State St.
5TH FL
Boston, MA 02109-2906
Phone (617) 505-1520

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20100907000649 PA Practitioner - Family Practice 9931223336 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Philadelphia College of Osteopathic Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Integrated Medical Group P CGroup PAC ID 1355247180, 105 clinicians

Practice addresses (Care Compare)

1578 Bunting St
Pottsville, PA 17901-8587
Phone (570) 622-0200

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Img Nursing Home Care, P.C. Family Medicine CurrentSince Jan 21, 2025 Accepting new patients
Schuylkill Health System Medical Group, Inc. Family Medicine CurrentSince Mar 25, 2019 Accepting new patients
Integrated Medical Group P C Family Medicine CurrentSince Jul 1, 2024 Accepting new patients
Schuylkill Health System Medical Group, Inc. Family Medicine CurrentSince Mar 25, 2019 Accepting new patients
Family Care Centers Inc. Family Medicine Current Accepting new patients
Family Care Centers Inc Family Medicine CurrentSince Jan 12, 2023 Accepting new patients
Form Health Associates Ma, P.C. Family Medicine CurrentSince Jan 1, 2026 Accepting new patients
Integrated Medical Group, P.C. CurrentSince Jul 1, 2024 Accepting new patients
Integrated Medical Group Past Accepting new patients

Locations

109 State St
Ste 5
Boston, MA 02109

103 Broad St
Ste B
Ashland, PA 17921
Phone (570) 477-6721

120 Burrus Blvd
Brodheadsville, PA 18322
Phone (570) 402-6101

200 E Brown St
East Stroudsburg, PA 18301
Phone (570) 476-3700

500 Plaza Ct
East Stroudsburg, PA 18301
Phone (570) 426-2330

232 Sunbury St
Minersville, PA 17954
Phone (570) 544-4590

1260 Centre Tpke
Ste 108
Orwigsburg, PA 17961
Phone (570) 516-9647

100 S Juniper St
Fl 3
Philadelphia, PA 19107
Phone (267) 999-9534

8 Oak Grove Rd
Ste 1
Pine Grove, PA 17963
Phone (570) 345-3321

700 Schuylkill Manor Rd
Ste 3
Pottsville, PA 17901
Phone (570) 621-4440

420 S Jackson St
Pottsville, PA 17901
Phone (570) 621-5000

700 E Norwegian St
Pottsville, PA 17901
Phone (570) 621-4000

205 E Laurel Blvd
Pottsville, PA 17901
Phone (570) 622-1887

48 Tunnel Rd
Ste 104
Pottsville, PA 17901
Phone (570) 622-5555

82 Tunnel Rd
Pottsville, PA 17901
Phone (570) 622-5455

1578 Bunting St
Pottsville, PA 17901
Phone (570) 544-4700

502 S 2nd St
Ste B
Saint Clair, PA 17970
Phone (570) 621-4364

Interoperability endpoints

  • Direct secure messaging: mmady@imgpc.medentdirect.com

Organizations & group practices 9

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.

Hospital & facility affiliations 28

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 28

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774569600000",
    "number": "1760641328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 STATE ST.",
            "address_2": "5TH FL",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021092906",
            "telephone_number": "617-505-1520",
            "fax_number": "617-928-8401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SOUTH JUNIPER",
            "address_2": "3RD FLOOR #8528",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191071316",
            "telephone_number": "617-505-1520",
            "fax_number": "617-928-8401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADY",
        "first_name": "MACKENZIE",
        "middle_name": "ALEECE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-08",
        "last_updated": "2026-03-27",
        "certification_date": "2026-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS015038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.