Active NPI
McKenzie Johnsen, PA-C
- Physician Assistant
- Saratoga Springs, UT
National Provider Identifier
1922798669
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 14181685-1206
- Practice address
- 62 E Thrive Dr Ste 220
Saratoga Springs, UT 84045-5560 - Phone
- (801) 768-8800
- NPI assigned
- May 8, 2023
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 14181685-1206 | UT | Primary |
Addresses
Primary practice location
62 E Thrive Dr Ste 220
Saratoga Springs, UT 84045-5560
Mailing address
10323 N Mesquite Way
Cedar Hills, UT 84062-8067
Phone (801) 430-7357
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2024
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
62 E Thrive Dr
Suite 220
Saratoga Springs, UT 84045-5560
Phone (801) 768-8800
680 E Main St
Suite 201
Lehi, UT 84043-2251
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
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.
-
- Dermatology Physician
- Lehi, UT
- NPI 1922368927
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1683504000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726617600000",
"number": "1922798669",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10323 N MESQUITE WAY",
"city": "CEDAR HILLS",
"state": "UT",
"postal_code": "840628067",
"telephone_number": "801-430-7357"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "62 E THRIVE DR STE 220",
"city": "SARATOGA SPRINGS",
"state": "UT",
"postal_code": "840455560",
"telephone_number": "801-768-8800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSEN",
"first_name": "MCKENZIE",
"credential": "PA-C",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-05-08",
"last_updated": "2024-09-18",
"certification_date": "2024-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "UT",
"license": "14181685-1206",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saratoga Springs, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.