Mackenzie Elizabeth Goodwin, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601007972 Issued in MI

Practice address

375 Eureka Rd Ste B
Wyandotte, MI 48192-5839

Phone

(734) 258-8386

NPI assigned

Oct 17, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Physician Assistant

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Pure Psychiatry of Michigan PLLCGroup PAC ID 1254741283, 102 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: purepsychiatryofmichigan.mackenziegoodwin@153418.advancedmd-direct.com

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.

• Pure Psychiatry of Michigan PLLC

  • Physician Assistant
  • Wayne, MI
  • NPI 1831701671
  Medicare reassignment Care Compare group
• Taylor Urgent Care PC

  • Urgent Care Clinic/Center
  • Taylor, MI
  • NPI 1013321033
  Medicare reassignment NPD
• Best Urgent Care PC

  • Urgent Care Clinic/Center
  • Redford, MI
  • NPI 1952791105
  Medicare reassignment
• Canton Urgent Care Walk-in Clinic PC

  • Urgent Care Clinic/Center
  • Canton, MI
  • NPI 1649712480
  Medicare reassignment
• Sacred Heart Rehabilitation Center, Inc.

  • Substance Abuse Rehabilitation Facility
  • Richmond, MI
  • NPI 1750363305
  Medicare reassignment
• Ypsilanti Urgent Care Walk-in Clinic

  • Urgent Care Clinic/Center
  • Ypsilanti, MI
  • NPI 1881048494
  Medicare reassignment
• Sacred Heart Rehabilitation Center, Inc

  • Community/Behavioral Health Agency
  • Flint, MI
  • NPI 1104959493
  NPD
• Sacred Heart Rehabilitation Center, Inc

  • Community/Behavioral Health Agency
  • Madison Heights, MI
  • NPI 1942510516
  NPD

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721606400000",
    "number": "1801347661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 EUREKA RD STE B",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481925839",
            "telephone_number": "734-258-8386"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 EUREKA RD STE B",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481925839",
            "telephone_number": "734-258-8386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOODWIN",
        "first_name": "MACKENZIE",
        "middle_name": "ELIZABETH",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-17",
        "last_updated": "2024-07-22",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601007972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Romika Tanelle Glenn, RN, MSN, NP-C
• Brittany N Glines, PA
• Mark Stephen Glovis, D.D.S.
• Benjamin David Gold, D.O.
• Wanaki Goodson, RN
• Kathryn Gordon
• Eileen H. Gorski, P.T.A.
• Anita Mari Gosselin
• Ari S. Gotlib, MD
• Al DG Mandeoya Grande, OTRL

• Physician Assistant in Wyandotte, MI
• Providers in Wyandotte, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.