Mackenzie Bronson, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

A209246 Issued in CA

Practice address

2201 South Ave
South Lake Tahoe, CA 96150-7025

Phone

(530) 543-5550

Fax

(530) 542-8734

NPI assigned

Mar 22, 2023

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mbronson256861@direct.childrenscolorado.org

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.

• Children'S Hospital Colorado

  • Clinical Social Worker
  • Aurora, CO
  • NPI 1174282776
  NPD
• Cynthia Gulick, PC

  • Family Medicine Physician
  • Tigard, OR
  • NPI 1467675009
  NPD

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

{
    "created_epoch": "1679443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788912000000",
    "number": "1992408868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2170 SOUTH AVE",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961507026",
            "telephone_number": "530-541-3420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 SOUTH AVE",
            "city": "SOUTH LAKE TAHOE",
            "state": "CA",
            "postal_code": "961507025",
            "telephone_number": "530-543-5550",
            "fax_number": "530-542-8734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRONSON",
        "first_name": "MACKENZIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-22",
        "last_updated": "2026-09-09",
        "certification_date": "2026-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A209246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allison V Brewer, MD
• Brian Hunt, MD, Inc
• Jordan Briede
• Chelsea C Brierly, MA MFT
• Kaye Mary Brindley, LCSW
• Harrison Thomas Calhoun Brown, DPT
• Nancy Bru, DPT, PT
• Veronica Helene Bruce, CNS
• Shannon Bruckbauer
• Azadeh Brumand, D.O.

• Pediatrics Physician in South Lake Tahoe, CA
• Providers in South Lake Tahoe, CA by specialty
• Pediatrics Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2026; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.