MACKENZIE BAKER (PA) – Physician Assistant, NPI 1104204221

MACKENZIE BAKER (PA) is a healthcare provider. based in Miamisburg, Ohio. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 50.006106RX (OH). The NPI Number for MACKENZIE BAKER (PA) is 1104204221

Main info

Female
Sole Proprietor
7 Years Of Experience
Accepts Medicare Assignment
Name
MACKENZIE BAKER (PA)
NPI
1104204221
Phone
(937) 436-4658
Address
3131 NEWMARK DR STE 220
Enumeration Date
8 May 2015
Last Update Date
5 May 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8557432247
Graduation Year
2019 (7 years ago)
PAC ID
9638409147
Group Practice PAC ID
2163969650
Professional Enrollment ID
I20190926001201
Address ID
OH432196223CO4400XCMNS301
Telehealth
Yes
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:11State licenses:1Digital endpointsOther names

5,032 PHYSICIAN ASSISTANT in OH

Provider Addresses for MACKENZIE BAKER (PA)

  • 3131 NEWMARK DR STE 220

    MIAMISBURG, OH 453425400

    Phone: (937) 436-4658

    Fax: (937) 436-4984

    Type: Mailing

  • 3535 SOUTHERN BLVD

    KETTERING, OH 454291221

    Phone: (937) 395-8166

    Fax: (937) 395-8347

    Type: Location

  • 6147 State Route 122

    Middletown, OH 450055201

    Phone: (513) 261-3410

    Fax: (513) 261-3419

    Type: Location

  • 4000 Miamisburg Centerville Rd

    Miamisburg, OH 453427615

    Phone: (937) 384-8791

    Fax: (937) 384-8729

    Type: Location

  • 405 W Grand Ave

    Dayton, OH 454057538

    Phone: (937) 723-3211

    Fax: (937) 723-4609

    Type: Location

  • 450 Washington Jackson Rd Ste F

    Eaton, OH 453208699

    Phone: (937) 456-8376

    Fax: (937) 456-8377

    Type: Location

  • 600 W Main St

    Troy, OH 453732928

    Phone: (937) 980-7010

    Fax: (937) 980-7019

    Type: Location

  • 1141 N Monroe Dr

    Xenia, OH 453851619

    Phone: (937) 352-2500

    Fax: (937) 352-3501

    Type: Location

  • 1997 Miamisburg Centerville Rd

    Centerville, OH 454593811

    Phone: (937) 401-6228

    Fax: (937) 401-6447

    Type: Location

  • 3535 Pentagon Blvd

    Beavercreek, OH 454311705

    Phone: (937) 702-4500

    Fax: (937) 702-4509

    Type: Location

  • 100 Kettering Way

    Franklin, OH 450051155

    Phone: (937) 458-4700

    Fax: (937) 458-4737

    Type: Location

  • 8701 Old Troy Pike

    Huber Heights, OH 454241066

    Phone: (937) 558-3338

    Fax: (937) 558-3349

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $27.

Total Amount is formed as General ($27) + Research ($0) + Ownership ($0) = $27.

Last reported payment date: 2024-01-09 • Largest payer in this snapshot: ACADIA Pharmaceuticals Inc ($14).

Total Amount

$27

General + Research + Ownership

Payments

2

Total payment records

General Amount

$27

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-01-09

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2019-09-26

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
I20190926001201IPhysician AssistantOHTBD

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
99309Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes34874$0
99284Emergency department visit with moderate level of medical decision making2222$0
99308Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes1611$0
99497Advance care planning, first 30 minutes1613$0
99310Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes1211$0
View full utilization report →

Insurance plans in this area (ZIP 45342)

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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: 2163969650View full group profile
NameSpecialtyState
Nurse PractitionerNC
Physician AssistantKY
Nurse PractitionerPA
Family PracticeNY
Nurse PractitionerCA
Nurse PractitionerIN
Nurse PractitionerIN
Nurse PractitionerIN
Physician AssistantNC
Nurse PractitionerIN

Reviews

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Frequently asked questions

What federal number belongs to MACKENZIE BAKER (PA)?
The federal identifier for MACKENZIE BAKER (PA) is NPI 1104204221.
Is MACKENZIE BAKER (PA)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What field does MACKENZIE BAKER (PA) work in?
You can think of MACKENZIE BAKER (PA) as practicing within Physician Assistant. Clinical services aligned with this taxonomy classification.
Where is MACKENZIE BAKER (PA)'s primary listing?
We display Miamisburg, Ohio because that is what the record indicates for MACKENZIE BAKER (PA).
What if Miamisburg, Ohio seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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