DR. MACKENZIE SHANE TRELOAR M.D.
NPI 1104273655
Student in an Organized Health Care Education/Training Program in Columbus, OH
About Dr. Mackenzie Shane Treloar M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. MACKENZIE SHANE TRELOAR M.D. (NPI 1104273655) is an individual student in an organized health care education/training program in Columbus, Ohio and active in the NPI registry since May 2016. She is enrolled in Medicare PECOS and is a graduate of University Of Iowa, Rj & L Carver College Of Medicine (2016).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Mackenzie Shane Treloar M.d. 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.
Medicare Billing Reassignment
Medicare enrollment records show Mackenzie Treloar reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Stockton, CA 95210
- Reassigned Medicare billing, California enrollment
- 20,078 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
COLUMBUS, OH 43210
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mackenzie Treloar's NPI number?
The NPI number for Mackenzie Treloar is 1104273655. It was assigned to this individual provider in the NPPES registry on May 14, 2016.
Where is Mackenzie Treloar located?
Mackenzie Treloar practices at 410 W 10th Ave, Columbus, OH 43210. The listed phone number is (614) 293-8045.
What is Mackenzie Treloar's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Mackenzie Treloar enrolled in Medicare?
Yes. Mackenzie Treloar is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Mackenzie Treloar's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mackenzie Treloar reassigns Medicare benefits to Permanente Medical Group Inc (Stockton, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mackenzie Treloar's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Mackenzie Treloar was last updated on December 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years 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.
# Dr. Mackenzie Shane Treloar, M.D. · NPI 1104273655
Student in an Organized Health Care Education/Training Program provider in Columbus, Ohio. Individual provider, active in the CMS NPPES registry since May 14, 2016.
## Identity
- **NPI:** 1104273655 (Entity type: Individual)
- **Enumerated:** May 14, 2016
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** No
## Practice location
- **Address:** 410 W 10TH AVE, Columbus, OH 43210-1240
- **Phone:** (614) 293-8045
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Permanente Medical Group Inc (NPI 1548343510, Stockton, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Iowa, Rj & L Carver College Of Medicine, class of 2016
## Record status
- **NPPES last updated:** December 17, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1104273655) · Data from the CMS NPPES public registry.