Individual provider Active NPI

Mackenzie Erin Powers, PA-C

  • Physician Assistant
  • Chicago, IL
National Provider Identifier
1952812182
Registry record updated Feb 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
085.006854 Issued in IL
Practice address
259 E Erie St FL 17
Chicago, IL 60611-2987
Phone
(312) 926-6000
NPI assigned
Oct 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 54803 CA
Physician Assistant 363A00000X 085.006854 IL Primary

Addresses

Primary practice location

259 E Erie St FL 17
Chicago, IL 60611-2987

Mailing address

259 E Erie St FL 17
Chicago, IL 60611-2987
Phone (312) 926-6000

Other practice location 1

701 Sunrise Ave
Roseville, CA 95661-4502
Phone (916) 772-6337

Other practice location 2

2650 Ridge Ave
Evanston, IL 60201
Phone (651) 497-5625

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, MP2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20181218002264 IL Practitioner - Physician Assistant 5698010791 Reassigns benefits to 1 organization
I20250606001960 MP Practitioner - Physician Assistant 5698010791 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
54803CAMDGeneral Practice Dentistry
085.006854ILMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Healthcare Corporation CurrentSince Apr 1, 2025 Accepting new patients
Endeavor Health Medical Group CurrentSince Dec 5, 2018 Accepting new patients
Commonwealth Healthcare Corporation CurrentSince Apr 1, 2025 Accepting new patients

Locations

9532 Eagle Way
Chicago, IL 60678

2650 Ridge Ave
Ste 2218A
Evanston, IL 60201
Phone (847) 503-4222

2650 Ridge Ave
Evanston, IL 60201
Phone (847) 570-1206

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1508025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582588800000",
    "number": "1952812182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST FL 17",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112987",
            "telephone_number": "312-926-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST FL 17",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112987",
            "telephone_number": "312-926-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Sunrise Ave",
            "address_purpose": "LOCATION",
            "city": "Roseville",
            "state": "CA",
            "postal_code": "956614502",
            "country_code": "US",
            "telephone_number": "916-772-6337",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2650 Ridge Ave",
            "address_purpose": "LOCATION",
            "city": "Evanston",
            "state": "IL",
            "postal_code": "60201",
            "country_code": "US",
            "telephone_number": "651-497-5625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POWERS",
        "first_name": "MACKENZIE",
        "middle_name": "ERIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-15",
        "last_updated": "2020-02-25",
        "certification_date": "2020-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "54803",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IL",
            "license": "085.006854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.