MACKENZIE FAY FORD (PA-C) – Emergency Medicine Physician, NPI 1619629532

MACKENZIE FAY FORD (PA-C) is a healthcare provider. based in Norton shores, Michigan. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 5601010988 (MI). The NPI Number for MACKENZIE FAY FORD (PA-C) is 1619629532

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
MACKENZIE FAY FORD (PA-C)
NPI
1619629532
Phone
Not provided
Address
800 E ELLIS RD # 571
Enumeration Date
21 January 2022
Last Update Date
17 March 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2317284601
Graduation Year
2021 (5 years ago)
PAC ID
2365836905
Group Practice PAC ID
3375938889
Professional Enrollment ID
I20220225000341
Address ID
MI494441849MU1500XBLVD404
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness85
Years active:4State licenses:1Digital endpointsOther names

6,069 PHYSICIAN ASSISTANT in MI

Provider Addresses for MACKENZIE FAY FORD (PA-C)

  • 800 E ELLIS RD # 571

    NORTON SHORES, MI 494415622

    Phone:

    Type: Mailing

  • 1500 E SHERMAN BLVD

    MUSKEGON, MI 494441849

    Phone: (231) 672-2000

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2022-02-25

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20220225000341IPhysician AssistantMITBD

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.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making4948$0
99284Emergency department visit with moderate level of medical decision making4642$0
99283Emergency department visit with low level of medical decision making1919$0
View full utilization report →

Insurance plans in this area (ZIP 49441)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3375938889View full group profile
NameSpecialtyState
Physician AssistantMI
Nurse PractitionerMI
Emergency MedicineMI
Emergency MedicineMI
Physician AssistantMI
Emergency MedicineWI
Emergency MedicineCA
Physician AssistantMI
Emergency MedicineMI
Physician AssistantMI

Reviews

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Frequently asked questions

What is the 10-digit NPI for MACKENZIE FAY FORD (PA-C)?
MACKENZIE FAY FORD (PA-C) — NPI 1619629532 — is the standard way to identify this listing.
Can I rely on MACKENZIE FAY FORD (PA-C) being an active provider?
As of the registry snapshot, MACKENZIE FAY FORD (PA-C) is marked active.
What is MACKENZIE FAY FORD (PA-C)'s specialty?
The listing groups MACKENZIE FAY FORD (PA-C) with Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
Where is MACKENZIE FAY FORD (PA-C) based?
MACKENZIE FAY FORD (PA-C) is tied to Norton Shores, Michigan in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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