MCKENZIE VI REYNOLDS – Physician Assistant, NPI 1902415219

MCKENZIE VI REYNOLDS is a healthcare provider. based in Santa clara, Utah. specializing in Physician Assistant. They hold a License No. 12474301-1206 (UT). The NPI Number for MCKENZIE VI REYNOLDS is 1902415219

Main info

Female
Name
MCKENZIE VI REYNOLDS
NPI
1902415219
Phone
(425) 315-5702
Address
786 LEDA LN
Enumeration Date
23 July 2020
Last Update Date
20 December 2021

Contacts

Secure Messaging
mreynolds548071@direct.med.utah.edu
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience39
Completeness85
Years active:5State licenses:1Other namesUpdated within 12 months

Provider Addresses for MCKENZIE VI REYNOLDS

  • 786 LEDA LN

    SANTA CLARA, UT 847655665

    Phone: (425) 315-5702

    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)

CMS reports 1 Open Payments records for all available years, with a total value of $144.

Total Amount is formed as General ($144) + Research ($0) + Ownership ($0) = $144.

Last reported payment date: 2024-05-16 • Largest payer in this snapshot: Janssen Pharmaceuticals, Inc ($144).

Total Amount

$144

General + Research + Ownership

Payments

1

Total payment records

General Amount

$144

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-05-16

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: 2021-11-11

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
I20211111001011IPhysician AssistantUTTBD

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 84765)

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Reviews

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Frequently asked questions

How is MCKENZIE VI REYNOLDS identified in CMS data?
CMS-hosted NPPES data lists MCKENZIE VI REYNOLDS with NPI 1902415219.
Can I rely on MCKENZIE VI REYNOLDS being an active provider?
As of the registry snapshot, MCKENZIE VI REYNOLDS is marked active.
What healthcare role does MCKENZIE VI REYNOLDS hold?
Scheduling teams often label MCKENZIE VI REYNOLDS under Physician Assistant. Clinical services aligned with this taxonomy classification.
What address line appears for MCKENZIE VI REYNOLDS?
MCKENZIE VI REYNOLDS's geographic hint is Santa Clara, Utah in our summary view.
Why does MCKENZIE VI REYNOLDS have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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