MRS. MACKENZIE BRANNON BONILLA REYES PA-C
NPI 1073360277
Physician Assistant in Charlotte, NC

Q: What is Mackenzie Bonilla Reyes's NPI number?

The NPI number for Mackenzie Bonilla Reyes is 1073360277. It was assigned to this individual provider in the NPPES registry on May 4, 2024. The provider is also known as Mackenzie Brannon Gray.

Q: What is Mackenzie Bonilla Reyes's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Active since May 04, 2024PECOS EnrolledAccepts Medicare Assignment

1000 BLYTHE BLVD, CHARLOTTE, NC 28203(704) 446-5185(704) 446-0221 Get Directions Write a Review

NPPES record last updated: January 28, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 26, 2024, Aug 21, 2024, May 4, 2024 (3 updates tracked since 2024).

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About Mrs. Mackenzie Brannon Bonilla Reyes Pa-c NPPES

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

MRS. MACKENZIE BRANNON BONILLA REYES PA-C (NPI 1073360277) is an individual physician assistant in Charlotte, North Carolina, licensed in North Carolina (0010-15028) and active in the NPI registry since May 2024. She is enrolled in Medicare PECOS and is a graduate of Other (2024).

NPPES Registry Identity

NPI1073360277

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMRS. MACKENZIE BRANNON BONILLA REYESCredential: PA-C

Location Address1000 BLYTHE BLVDCharlotte, NC 28203-5812

Mailing Address327 Houston St NeConcord, NC 28025-3258

Phone(704) 446-5185

Fax(704) 446-0221

Sole ProprietorYes

Medical School CMSOtherGraduated 2024

Enumeration DateMay 4, 2024

Last NPPES UpdateJanuary 28, 20253 updates tracked since enumeration

NPPES CertifiedJanuary 28, 2025

✔ NPI 1073360277 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in NC · 0010-15028

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

1000 BLYTHE BLVD, Charlotte, NC 28203

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Other Names 1

Former Name (1)Mackenzie Brannon Gray

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of NC, Oscar Health Plan of North Carolina, Inc.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mrs. Mackenzie Brannon Bonilla Reyes Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1456874965

PECOS Enrollment IDI20250325003282

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 28203 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

$83.90 typical visit price

range $54.12 – $165.09

Typical copayment $20.97 (range $13.53 – $41.27)

Most-billed visit code 99203

Established Patient

$67.72 typical visit price

range $17.21 – $134.61

Typical copayment $16.93 (range $4.30 – $33.65)

Most-billed visit code 99213

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.

JENNIFER EGAN M.D.

Pathology (Clinical Pathology/Laboratory Medicine)