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MACKENZIE J WEIS
NPI 1104636547
Physician Assistant in South Haven, MN

Active since January 08, 2025PECOS EnrolledAccepts Medicare Assignment
306 149TH ST, SOUTH HAVEN, MN 55382(320) 291-0229 Get Directions Write a Review

NPPES record last updated: July 2, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 2, 2025, Jan 8, 2025 (2 updates tracked since 2025).

About Mackenzie J Weis NPPES

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

MACKENZIE J WEIS (NPI 1104636547) is an individual physician assistant in South Haven, Minnesota, licensed in Minnesota (15408) and active in the NPI registry since January 2025. She is enrolled in Medicare PECOS, is affiliated with St Cloud Hospital, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1104636547
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMACKENZIE J WEIS
Location Address306 149TH STSouth Haven, MN 55382-9140
Mailing Address306 149th StSouth Haven, MN 55382-9140 · (320) 291-0229
Phone(320) 291-0229
Sole ProprietorYes
Medical School CMSOtherGraduated 2025
Enumeration DateJanuary 8, 2025
Last NPPES UpdateJuly 2, 20252 updates tracked since enumeration
NPPES CertifiedJuly 2, 2025
✔ NPI 1104636547 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in MN · 15408
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.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
306 149TH ST, South Haven, MN 55382
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.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

Mackenzie J Weis 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 ID9335647767
PECOS Enrollment IDI20250813003540
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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Cloud Hospital

Acute Care Hospitals · Saint Cloud, MN
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number240036
Location1406 6th Ave NorthSaint Cloud, MN 56303 · Stearns County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55382 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
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
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.

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 Weis's NPI number?

The NPI number for Mackenzie Weis is 1104636547. It was assigned to this individual provider in the NPPES registry on January 8, 2025.

Where is Mackenzie Weis located?

Mackenzie Weis practices at 306 149th St, South Haven, MN 55382. The listed phone number is (320) 291-0229.

What is Mackenzie Weis's specialty?

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

Is Mackenzie Weis enrolled in Medicare?

Yes. Mackenzie Weis 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.

What insurance does Mackenzie Weis accept?

Health plans from HealthPartners list Mackenzie Weis as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Mackenzie Weis affiliated with any hospitals?

According to CMS data, Mackenzie Weis is affiliated with St Cloud Hospital.

When was this NPI record last updated?

The NPPES record for Mackenzie Weis was last updated on July 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months 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.