MACKENZIE RICHARD (DPT) – Physical Therapist, NPI 1073490363

MACKENZIE RICHARD (DPT) is a healthcare provider. based in Austin, Texas. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. 1407169 (TX). The NPI Number for MACKENZIE RICHARD (DPT) is 1073490363

Main info

Female
1 Year Of Experience
Accepts Medicare Assignment
Name
MACKENZIE RICHARD (DPT)
NPI
1073490363
Phone
(737) 204-0089
Address
4225 GUADALUPE ST
Enumeration Date
19 August 2025
Last Update Date
19 August 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7372040089
Graduation Year
2025 (1 year ago)
PAC ID
0749781656
Group Practice PAC ID
5890988216
Professional Enrollment ID
I20250902001800
Address ID
TX787514224AU4225XSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience24
Completeness85
Years active:0State licenses:1Digital endpointsOther names

5,353 PHYSICAL THERAPIST IN PRIVATE PRACTICE in TX

Provider Addresses for MACKENZIE RICHARD (DPT)

  • 4225 GUADALUPE ST

    AUSTIN, TX 787514224

    Phone: (737) 204-0089

    Mailing address matches the actual address.

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: 2025-09-02

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
I20250902001800IPhysical Therapist In Private PracticeTXTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 78751)

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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: 5890988216View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeTX
Occupational Therapist In Private PracticeTX
-TX
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeTX
Physical Therapist In Private PracticeTX
-TX
-TX
Physical Therapist In Private PracticeTX

Reviews

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Frequently asked questions

Can I use this page to confirm MACKENZIE RICHARD (DPT)'s NPI?
Yes. MACKENZIE RICHARD (DPT) is listed with NPI 1073490363 in the public NPI dataset.
Is MACKENZIE RICHARD (DPT) listed as active for patients and plans?
The listing shows MACKENZIE RICHARD (DPT) as active in the NPI system.
What taxonomy line describes MACKENZIE RICHARD (DPT)?
For research purposes, treat MACKENZIE RICHARD (DPT) as Physical Therapist in this dataset. Clinical services aligned with this taxonomy classification.
Where is MACKENZIE RICHARD (DPT) based?
MACKENZIE RICHARD (DPT) is tied to Austin, Texas in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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