MACKENZIE ANNE MCCROREY PA-C NPI 1023271632

NPI Information

NPI: 1023271632
Provider Name: MACKENZIE ANNE MCCROREY, PA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

PECOS Registration: Yes

Address:
10000 SE MAIN ST STE 365
PORTLAND, OR
ZIP 97216
Phone: (503) 261-4430
Get Directions

Mackenzie Anne Mccrorey, PA-C is a surgical physician assistant in Portland, OR with 16 years of experience. Mackenzie Anne Mccrorey, PA-C NPI is 1023271632. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

10000 SE MAIN ST STE 365
PORTLAND, OR
ZIP 97216-474
Phone: (503) 261-4430
Fax: (503) 261-4436

The NPI 1023271632 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/3/2008 and was last updated on 1/10/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363A00000X	Physician Assistant		085003524	ILLINOIS	No
2	363AS0400X	Physician Assistant	Surgical	085003524	ILLINOIS	No
3	363AS0400X	Physician Assistant	Surgical	PA195380	OREGON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	P01216933	OTHER	ILLINOIS	MEDICARE RAILROAD (PROVIDER PTAN)
2	206147	OTHER	ILLINOIS	MEDICARE (GROUP PTAN)
3	206147235	OTHER	ILLINOIS	MEDICARE (INDIVIDUAL)
4	CA4748	OTHER	ILLINOIS	MEDICARE RAILROAD (GROUP PTAN)

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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