Active NPI
Mackenzie Miller, PSY.D., LP
- Clinical Psychologist
- Minneapolis, MN
National Provider Identifier
1912659277
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- LP5139
- Practice address
- 800 E 28TH St
Minneapolis, MN 55407-3723 - Phone
- (612) 863-4000
- NPI assigned
- Jan 18, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | LP5139 | MN | Primary |
Addresses
Primary practice location
800 E 28TH St
Minneapolis, MN 55407-3723
Mailing address
5790 Bartlett Blvd
Mound, MN 55364-1401
Phone (612) 910-7245
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
800 E 28TH St
Minneapolis, MN 55407-3723
Phone (612) 262-8425
Hospital & facility affiliations
- Abbott Northwestern Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.6 of 100
- Quality
- 72.5
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 77.07
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Allina Health System | Current | Accepting new patients | |
| Allina Health System | Current | Accepting new patients | |
| Allina Health System | Current | Accepting new patients |
Locations
800 E 28th St
Minneapolis, MN 55407
Phone (612) 863-3547
2215 Park Ave
Minneapolis, MN 55404
Phone (612) 775-8800
2925 Chicago Ave
#10957
Minneapolis, MN 55407
Phone (612) 262-8640
Interoperability endpoints
- mmiller578416@excellian.direct.allina.com
Organizations & group practices 3
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.
-
- Obstetrics & Gynecology Physician
- Buffalo, MN
- NPI 1295272342
-
- Psychiatry Physician
- Minneapolis, MN
- NPI 1346282563
-
- Rheumatology Physician
- Coon Rapids, MN
- NPI 1952146516
Hospital & facility affiliations 23
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Obesity Medicine (Family Medicine) Physician
- Minneapolis, MN
- NPI 1154684835
Hospital
-
- Physical Medicine & Rehabilitation Physician
- Minneapolis, MN
- NPI 1275577215
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1642464000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642464000000",
"number": "1912659277",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5790 BARTLETT BLVD",
"city": "MOUND",
"state": "MN",
"postal_code": "553641401",
"telephone_number": "612-910-7245"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 E 28TH ST",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554073723",
"telephone_number": "612-863-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "MACKENZIE",
"name_prefix": "Dr.",
"credential": "PSY.D., LP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-18",
"last_updated": "2022-01-18",
"certification_date": "2022-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MN",
"license": "LP5139",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2022; 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.