Individual provider Active NPI

Mackenzie Rose Kilpatrick, PA-C

  • Medical Physician Assistant
  • Wethersfield, CT
National Provider Identifier
1891331211
Registry record updated May 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
4639 Issued in CT
Practice address
988 Silas Deane Hwy
Wethersfield, CT 06109-4227
Phone
(860) 493-1950
NPI assigned
Nov 20, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 4639 CT Primary

Addresses

Primary practice location

988 Silas Deane Hwy
Wethersfield, CT 06109-4227

Mailing address

988 Silas Deane Hwy
Wethersfield, CT 06109-4227
Phone (860) 493-1950

Other names 1

  • Miss Mackenzie Rose Martin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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

Enrollment IDStateProvider typePAC IDDetails
I20200214001214 CT Practitioner - Physician Assistant 8022444884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Connecticut Ear, Nose and Throat Associates, P.C.Group PAC ID 3870533730, 20 clinicians

Practice addresses (Care Compare)

988 Silas Deane Hwy
Wethersfield, CT 06109-4227
Phone (860) 493-1950

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.45 of 100Reported as group
Quality
97.67
Promoting interoperability
100
Improvement activities
40
Cost
81.35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: mmartin265268@xdr.hhchealthdirect.org

Organizations & group practices 1

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.

Hospital & facility affiliations 2

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": "1574208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1778198400000",
    "number": "1891331211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "988 SILAS DEANE HWY",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094227",
            "telephone_number": "860-493-1950",
            "fax_number": "860-493-1961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "988 SILAS DEANE HWY",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061094227",
            "telephone_number": "860-493-1950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILPATRICK",
        "first_name": "MACKENZIE",
        "middle_name": "ROSE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-20",
        "last_updated": "2026-05-08",
        "certification_date": "2026-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "4639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MACKENZIE",
            "last_name": "MARTIN",
            "middle_name": "ROSE",
            "prefix": "MISS",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wethersfield, CT

Sources for this page

Verify at the official NPI Registry.