MR. GLEN CARLISLE MACKENZIE (MD) – Gynecology Physician, NPI 1306926704
Gynecology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
120 OBSTETRICS/GYNECOLOGY in VT
Provider Addresses for MR. GLEN CARLISLE MACKENZIE (MD)
1009 DEPOT ST
MANCHESTER CENTER, VT 052559731
Phone: (802) 442-8649
Fax: (802) 442-8658
Type: Mailing
Holden–Leonard Mill Complex, 160, Benmont Avenue, Downtown Bennington Historic District, Bennington, Bennington County, Vermont, 05201, United States
SUITE 22
BENNINGTON, VT 05201
Phone: (802) 442-8649
Fax: (802) 442-8658
Type: Mailing
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.
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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: 2005-09-06
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20050906000303 | I | Obstetrics/Gynecology | VT | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 96 | 32 | $0 |
| 96127 | Assessment of emotional or behavioral problems | 78 | 31 | $0 |
| 99215 | Established patient office or other outpatient visit, 40-54 minutes | 24 | 24 | $0 |
| 81003 | Automated urinalysis test | 16 | 13 | $0 |
Insurance plans in this area (ZIP 05255)
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