Mackenzie Lee Willman, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1265 W American Dr Ste 100
Neenah, WI 54956-1405

Phone

(920) 886-8979

NPI assigned

Mar 1, 2021

Last updated

Jan 4, 2023By the provider in NPPES

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 WI

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, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Bellin Memorial Hospital IncGroup PAC ID 8820900749, 685 clinicians

Oconto Hospital and Medical Center IncGroup PAC ID 2163461781, 217 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mwillman925948@direct.emplifyhealth.org

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.

• Oconto Hospital & Medical Center Inc

  dba Emplify Health Oconto Hospital

  • Critical Access Hospital
  • Oconto, WI
  • NPI 1356373302
  Medicare reassignment Care Compare group NPD (past)
• Bellin Memorial Hospital Inc

  dba Bellin Health Algoma

  • Rural Health Clinic/Center
  • Algoma, WI
  • NPI 1609838473
  Medicare reassignment Care Compare group
• Ascension Medical Group-Fox Valley Wisconsin, Inc

  dba Ascension Medical Group

  • Multi-Specialty Clinic/Center
  • Neenah, WI
  • NPI 1730126392
  Medicare reassignment NPD
• Wisconsin Institute of Urology SC

  • Urology Physician
  • Neenah, WI
  • NPI 1578872628
  Medicare reassignment
• Ascension Medical Group-Fox Valley Wisconsin, Inc

  • Cardiovascular Disease Physician
  • Appleton, WI
  • NPI 1831890177
  NPD
• Bellin Memorial Hospital Inc

  dba Bellin Health

  • Family Medicine Physician
  • Green Bay, WI
  • NPI 1033172390
  NPD
• Bellin Memorial Hospital Inc

  dba FMC East Depere

  • Family Medicine Physician
  • De Pere, WI
  • NPI 1780646513
  NPD
• Oconto Hospital & Medical Center Inc

  dba Bellin Health Suring

  • Rural Health Clinic/Center
  • Suring, WI
  • NPI 1104418037
  NPD
• Oconto Hospital & Medical Center Inc

  dba Bellin Health

  • Family Medicine Physician
  • Oconto, WI
  • NPI 1114579836

  Physician Assistant

  NPD
• Bellin Memorial Hospital Inc

  dba FMC Brillion

  • Family Medicine Physician
  • Brillion, WI
  • NPI 1962464784
  NPD (past)

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

{
    "created_epoch": "1614556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672790400000",
    "number": "1881288934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1265 W AMERICAN DR STE 100",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549561405",
            "telephone_number": "920-886-8979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 W AMERICAN DR STE 100",
            "city": "NEENAH",
            "state": "WI",
            "postal_code": "549561405",
            "telephone_number": "920-886-8979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLMAN",
        "first_name": "MACKENZIE",
        "middle_name": "LEE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-01",
        "last_updated": "2023-01-04",
        "certification_date": "2023-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah J Wilczek, PHARMD
• Randy Joseph Wild, O.D.
• Jenna R Wille, RN
• Christopher John Williams, APNP, ACNPC-AG
• Alex Willing
• Lauren Christine Wilmet, MSN, RN, APRN, FNP-C
• Edwin E Wilson, MD
• Winnebago Oral Surgery, S.C.
• Betsy R Winnekens, APNP
• Karen Sophia Winters, P.T.

• Physician Assistant in Neenah, WI
• Providers in Neenah, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2023; 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.