Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MACKENZIE RAYNE FANNIN DO
NPI 1003604836
Family Medicine in Rochester, MN

Q: What is Mackenzie Fannin's NPI number?

The NPI number for Mackenzie Fannin is 1003604836. It was assigned to this individual provider in the NPPES registry on April 30, 2025.

Q: What is Mackenzie Fannin's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Mackenzie Fannin was last updated on July 30, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 30, 2025PECOS Enrolled

200 1ST ST SW, ROCHESTER, MN 55905(507) 284-2511 Get Directions Write a Review

NPPES record last updated: July 30, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Mackenzie Rayne Fannin Do NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MACKENZIE RAYNE FANNIN DO (NPI 1003604836) is an individual family medicine provider in Rochester, Minnesota, licensed in Minnesota (83351) and active in the NPI registry since April 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1003604836

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameMACKENZIE RAYNE FANNINCredential: DO

Location Address200 1ST ST SWRochester, MN 55905-0001

Mailing AddressPo Box 860912Minneapolis, MN 55486-0912 · (507) 284-2511

Phone(507) 284-2511

Sole ProprietorNo

Enumeration DateApril 30, 2025

Last NPPES UpdateJuly 30, 2026

NPPES CertifiedJuly 30, 2026

✔ NPI 1003604836 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in MN · 83351✔ Licensed in MN · 35139

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

200 1ST ST SW, Rochester, MN 55905

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mackenzie Rayne Fannin Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55905 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$98.61 typical visit price

range $18.32 – $138.04

Typical copayment $24.65 (range $4.58 – $34.51)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EMILY LEASURE MD

Internal Medicine