Makenzie Brynn Duncan

Individual provider Active NPI Physician Assistant · La Salle, MI

NPI 1952921272 · NPPES record last updated Sep 16, 2022

Key facts

NPI
1952921272
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
License
10003146A (IN)
Practice address
3018 Yargerville Rd
La Salle, MI 48145-9792
Phone
(419) 350-9678
NPI assigned
Apr 17, 2020
Sex
Female
Sole proprietor
Yes

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.

Medicare Care Compare profile

Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverview Hospital (209 clinicians)

Practice addresses (Care Compare)

10830 N Michigan Rd
Riverview Health Emergency Room and Urgent Ca
Zionsville, IN 46077-8167
Phone (317) 764-5050

395 Westerfield Rd
Noblesville, IN 46060-1425

395 Westfield Dr
Noblesville, IN 46060-1425

395 Westfield FR
RM 2419
Noblesville, IN 46060-1425
Phone (317) 776-7157

395 Westfield Rd B
OB/GYN Specialists of Indiana
Noblesville, IN 46060-1425
Phone (317) 776-9440

395 Westfield Rd D
Noblesville Diabetic and Endocrinolog
Noblesville, IN 46060-1425
Phone (317) 776-3520

395 Westfield Rd RM
Noblesville, IN 46060-1425

9690 E 116TH St
Riverview Health Freestanding Emergency Urg
Fishers, IN 46037-2838
Phone (317) 773-0760

Merit-based Incentive Payment System (MIPS)

Final score
93.78 of 100 (apm)
Quality
80.38
Promoting interoperability
100
Improvement activities
40

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IN
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20220404001730 IN Practitioner - Physician Assistant 7113313917 Reassigns benefits to 2 organizations

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America LLC Multi-Specialty Current
since Apr 1, 2022
Accepting new patients
Cep America LLC Multi-Specialty Current
since Apr 1, 2022
Accepting new patients
Riverview Hospital Multi-Specialty Current
since Apr 25, 2022
Accepting new patients

Locations

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

1373 N State Road 62
Madison, IN 47250
Phone (812) 801-0196

395 Westfield Rd
Noblesville, IN 46060
Phone (317) 218-3136

1606 N 7th St
Terre Haute, IN 47804
Phone (812) 238-7523

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant
Group: 193200000X MULTI-SPECIALTY GROUP
363AM0700X 10003146A IN
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X 10003146A IN Yes

Addresses

Primary practice location

3018 Yargerville Rd
La Salle, MI 48145-9792

Mailing address

462 E 10TH St
Indianapolis, IN 46202-4600
Phone (419) 350-9678

Other providers in La Salle, MI

All providers in La Salle, MI · Physician Assistant in Michigan

Sources for this page

Verify at the official NPI Registry.