Individual provider Active NPI

Elizabeth Lauren Mackenzie, APRN

  • Family Nurse Practitioner
  • Cape Coral, FL
National Provider Identifier
1841841558
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APRN11007272 Issued in FL
Practice address
3571 Del Prado Blvd N Ste 2
Cape Coral, FL 33909-5287
Phone
(239) 656-6300
Fax
(239) 656-6765
NPI assigned
Sep 24, 2019
Last updated
Mar 13, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN11007272 FL Primary
Registered Nurse 163W00000X RN624002 PA

Addresses

Primary practice location

3571 Del Prado Blvd N Ste 2
Cape Coral, FL 33909-5287

Mailing address

2675 Winkler Ave FL 2
Fort Myers, FL 33901-9342
Phone (239) 656-6300

Other practice location 1

26322 Feathersound Dr
Punta Gorda, FL 33955-4713
Phone (443) 309-4134

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address elmackenzie@pacollege.edu Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, FL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210211000744 PA Practitioner - Nurse Practitioner 3678993516 Reassigns benefits to 1 organization
I20220309003295 FL Practitioner - Nurse Practitioner 3678993516 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians
Mana Health Partners PAGroup PAC ID 3971952813, 102 clinicians

Practice addresses (Care Compare)

7374 San Casa Dr
Englewood, FL 34224-8842
Phone (941) 417-5064

991 Pondella Rd
North Fort Myers, FL 33903-3500
Phone (732) 552-8922

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN624002PAMDRegistered Nurse
APRN11007272FLMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Millennium Physician Group LLC CurrentSince Mar 14, 2023 Accepting new patients
Infinite Medical PC CurrentSince Apr 1, 2021 Accepting new patients
Mana Health Partners PA CurrentSince Dec 1, 2023 Accepting new patients
Millennium Physician Group LLC CurrentSince Mar 14, 2023 Accepting new patients
Careconnectmd Florida P.a. CurrentSince Aug 1, 2024 Accepting new patients

Locations

3090 Bristol St
Ste 200
Costa Mesa, CA 92626
Phone (714) 992-1182

3571 Del Prado Blvd N
Ste 2
Cape Coral, FL 33909
Phone (239) 656-6300

2675 Winkler Ave
Fl 2
Fort Myers, FL 33901
Phone (855) 979-5700

3434 Hancock Bridge Pkwy
Ste 301
North Ft Myers, FL 33903
Phone 877856377411108

991 Pondella Rd
North Ft Myers, FL 33903
Phone (239) 994-8809

1317 Edgewater Dr
Orlando, FL 32804
Phone (877) 436-8527

19531 Cochran Blvd
Pt Charlotte, FL 33948
Phone (941) 255-3535

1507 S Tuttle Ave
Sarasota, FL 34239
Phone (941) 366-0336

338 Whitesville Rd
Ste 103
Jackson, NJ 08527

250 Skillman St
Ste 202
Brooklyn, NY 11205

498 Washington St
Easton, PA 18042
Phone (610) 253-4821

Interoperability endpoints

  • Direct secure messaging: elmackenzie@pacollege.edu

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.

NPI Registry JSON

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

{
    "created_epoch": "1569283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1841841558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 WINKLER AVE FL 2",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339019342",
            "telephone_number": "239-656-6300",
            "fax_number": "239-656-6765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3571 DEL PRADO BLVD N STE 2",
            "city": "CAPE CORAL",
            "state": "FL",
            "postal_code": "339095287",
            "telephone_number": "239-656-6300",
            "fax_number": "239-656-6765"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "26322 Feathersound Dr",
            "address_purpose": "LOCATION",
            "city": "Punta Gorda",
            "state": "FL",
            "postal_code": "339554713",
            "country_code": "US",
            "telephone_number": "443-309-4134",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MACKENZIE",
        "first_name": "ELIZABETH",
        "middle_name": "LAUREN",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-24",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "APRN11007272",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN624002",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "elmackenzie@pacollege.edu",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "107 Sunset Dr",
            "city": "East Earl",
            "state": "PA",
            "country_code": "US",
            "postal_code": "175199761",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cape Coral, FL

Sources for this page

Verify at the official NPI Registry.