MACKENZIE WALDRAN (PA) – Medical Physician Assistant, NPI 1689358780
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,202 PHYSICIAN ASSISTANT in AL
Provider Addresses for MACKENZIE WALDRAN (PA)
1215 7th St SE Ste 260
Decatur, AL 356013399
Phone: (256) 973-3630
Type: Location
17 GREENWICH CT
OAKMONT, PA 151391170
Phone: (989) 798-7821
Type: Mailing
2775 MOSSIDE BLVD
MONROEVILLE, PA 151462760
Phone: (412) 357-3000
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 11 Open Payments records for all available years, with a total value of $369.
Total Amount is formed as General ($369) + Research ($0) + Ownership ($0) = $369.
Last reported payment date: 2024-11-08 • Largest payer in this snapshot: W. L. Gore & Associates, Inc. ($105).
Total Amount
$369
General + Research + Ownership
Payments
11
Total payment records
General Amount
$369
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-08
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-10-16
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20240503002667 | I | Physician Assistant | AL | TBD |
| I20251016000075 | I | Physician Assistant | PA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 35601)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Anesthesiology, Critical Care (Intensivists) | PA | |
| Nurse Practitioner | PA | |
| - | PA | |
| Cardiac Surgery, General Surgery | PA | |
| Nurse Practitioner | PA | |
| - | PA | |
| - | MD | |
| - | SC | |
| - | PA | |
| - | PA |
Reviews
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