NPIMap

Individual provider Active NPI

Mackenzie Rae Lobitz, M. D.

  • Family Medicine Physician
  • Glencoe, MN
National Provider Identifier
1770841504
Registry record updated Apr 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
56623 Issued in MN
Practice address
1805 Hennepin Ave N
Glencoe, MN 55336-1416
Phone
(320) 864-3121
Fax
(320) 864-7998
NPI assigned
Apr 30, 2012
Last updated
Apr 14, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2022

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 56623 MN Primary

Addresses

Primary practice location

1805 Hennepin Ave N
Glencoe, MN 55336-1416

Mailing address

1805 Hennepin Ave N
Glencoe, MN 55336-1416
Phone (320) 864-3121

Other practice location 1

111 Hundertmark Rd
212 Medical Center #220
Chaska, MN 55318-4551
Phone (952) 448-2050

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mlobitz118911@excellian.direct.allina.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20130828000482 MN Practitioner - Family Practice 0547403248 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Minnesota Medical School, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glencoe Regional Health ServicesGroup PAC ID 1759292980, 45 clinicians

Practice addresses (Care Compare)

1805 Hennepin Ave N
Glencoe, MN 55336-1416
Phone (320) 864-3121

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St Francis Regional Medical Center CurrentSince Jan 1, 2016 Accepting new patients
St. Francis Regional Medical Center CurrentSince Jan 1, 2016 Accepting new patients
Glencoe Regional Health Services CurrentSince Mar 28, 2022 Accepting new patients
Glencoe Regional Health Services CurrentSince Mar 28, 2022 Accepting new patients
Glencoe Regional Health Services Past Accepting new patients

Locations

111 Hundertmark Rd
Ste 220
Chaska, MN 55318
Phone (952) 428-2050

1805 Hennepin Ave N
Glencoe, MN 55336
Phone (320) 864-3121

265 Creek Ln S
Jordan, MN 55352
Phone (952) 428-1200

1024 Central Ave
Lester Prairie, MN 55354
Phone (320) 395-2527

Interoperability endpoints

  • Direct secure messaging: mlobitz118911@excellian.direct.allina.com

Organizations & group practices 5

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 7

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": "1335744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1770841504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 HENNEPIN AVE N",
            "city": "GLENCOE",
            "state": "MN",
            "postal_code": "553361416",
            "telephone_number": "320-864-3121",
            "fax_number": "320-864-7998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 HENNEPIN AVE N",
            "city": "GLENCOE",
            "state": "MN",
            "postal_code": "553361416",
            "telephone_number": "320-864-3121",
            "fax_number": "320-864-7998"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Hundertmark Rd",
            "address_2": "212 Medical Center #220",
            "address_purpose": "LOCATION",
            "city": "Chaska",
            "state": "MN",
            "postal_code": "553184551",
            "country_code": "US",
            "telephone_number": "952-448-2050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LOBITZ",
        "first_name": "MACKENZIE",
        "middle_name": "RAE",
        "credential": "M. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-30",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "56623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mlobitz118911@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "1805 Hennepin Ave N",
            "city": "Glencoe",
            "state": "MN",
            "country_code": "US",
            "postal_code": "553361416",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Glencoe, MN

Sources for this page

Verify at the official NPI Registry.