Individual provider Active NPI

Mackenzie Hope Miller

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1932987286
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
520 W Fayette St Ste 300
Baltimore, MD 21201-1756
Phone
(443) 695-9453
NPI assigned
Sep 18, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

520 W Fayette St Ste 300
Baltimore, MD 21201-1756

Mailing address

1448 Patapsco St
Baltimore, MD 21230-4523
Phone (443) 695-9453

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20250226000844 MD Practitioner - Physician Assistant 0749700300 Reassigns benefits to 1 organization

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
St Paul Place Specialists, Inc.Group PAC ID 7719882943, 332 clinicians

Practice addresses (Care Compare)

301 Saint Paul St
Baltimore, MD 21202-2102

7602 Belair Rd
Baltimore, MD 21236-4088
Phone (410) 663-8100

Hospital & facility affiliations

  • Mercy Medical Center Inc Hospital, Baltimore, MD, CCN 210008

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
St. Paul Place Specialists, Inc. CurrentSince Jan 10, 2025 Accepting new patients
St Paul Place Specialists Inc CurrentSince Jan 10, 2025 Accepting new patients
Saint Paul Place Specialists, Inc. Past Accepting new patients

Locations

301 Saint Paul St
Baltimore, MD 21202
Phone (410) 385-4930

9821 Broken Land Pkwy
Columbia, MD 21046
Phone (410) 730-5700

7602 Belair Rd
Nottingham, MD 21236
Phone (410) 332-9654

Interoperability endpoints

  • Direct secure messaging: mmiller109707@direct.mdmercy.com

Organizations & group practices 4

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 1

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": "1694995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1932987286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1448 PATAPSCO ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212304523",
            "telephone_number": "443-695-9453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 W FAYETTE ST STE 300",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011756",
            "telephone_number": "443-695-9453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "MACKENZIE",
        "middle_name": "HOPE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-18",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.