Mackenzie Cole Intlehouse, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA11528 Issued in TX

Practice address

700 Olympic Plaza Cir Ste 600
Tyler, TX 75701-1954

Phone

(903) 596-3488

NPI assigned

Dec 28, 2017

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 TX

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Etmc Physician Group, Inc.Group PAC ID 4486915600, 375 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ut Health East Texas Jacksonville Hospital Hospital, Jacksonville, TX, CCN 450194
• Ut Health East Texas Rehabilitation Hospital Inpatient rehabilitation facility, Tyler, TX, CCN 453072

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Interoperability endpoints

• Direct secure messaging: mcole889480@ahs.direct-ci.com

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.

• Etmc Physician Group Inc.

  • Cardiovascular Disease Physician
  • Tyler, TX
  • NPI 1609382662
  Medicare reassignment Care Compare group
• Longview Orthopaedic Clinic Association

  • Orthopaedic Surgery Physician
  • Longview, TX
  • NPI 1053476259
  Medicare reassignment

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

• Jacksonville Hospital LLC

  dba UTHealth East Texas Jacksonville Hospital

  • General Acute Care Hospital
  • Jacksonville, TX
  • NPI 1730697350
  Care Compare affiliation
• Rehabilitation Hospital, LLC

  • Rehabilitation Hospital
  • Tyler, TX
  • NPI 1174021695

  Inpatient rehabilitation facility

  Care Compare affiliation

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

{
    "created_epoch": "1514419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1881100808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 OLYMPIC PLAZA CIR STE 600",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011954",
            "telephone_number": "903-596-3488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 OLYMPIC PLAZA CIR STE 600",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011954",
            "telephone_number": "903-596-3488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "INTLEHOUSE",
        "first_name": "MACKENZIE",
        "middle_name": "COLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-28",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA11528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Integrity Care Partners
• Integrity Family Home Care LLC (Choice Homecare)
• Integrity Health
• Intergrity Family Home Care LLC
• Interventional Spine Associates PA
• Donald Uchenna Iriele, RPH
• Ali Irshad, M.D.
• Patrice Irvin, PTA
• Leslie L Isaacs, RN
• Cicely Laneigh Isabell

• Surgical Physician Assistant in Tyler, TX
• Providers in Tyler, TX by specialty
• Surgical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.