MACKENZIE R TIDERINGTON P.A-C
NPI 1114577103
Physician Assistant in Dayton, OH

Q: What is Mackenzie Tiderington's NPI number?

The NPI number for Mackenzie Tiderington is 1114577103. It was assigned to this individual provider in the NPPES registry on September 12, 2019. The provider is also known as Mackenzie R Rice Pa-C.

Q: What is Mackenzie Tiderington's specialty?

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

Active since September 12, 2019PECOS EnrolledAccepts Medicare Assignment

93.2/100

CMS Quality Rating

4160 LITTLE YORK RD STE 10, DAYTON, OH 45414(937) 415-9100(937) 415-9191 Get Directions Write a Review

NPPES record last updated: December 4, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 4, 2022, Sep 12, 2019 (2 updates tracked since 2019).

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About Mackenzie R Tiderington P.a-c NPPES

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

MACKENZIE R TIDERINGTON P.A-C (NPI 1114577103) is an individual physician assistant in Dayton, Ohio, licensed in Ohio (50.006159RX) and active in the NPI registry since September 2019. She is enrolled in Medicare PECOS, is affiliated with Wilson Memorial Hospital, and is a graduate of Other (2019).

NPPES Registry Identity

NPI1114577103

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMACKENZIE R TIDERINGTONCredential: P.A-C

Location Address4160 LITTLE YORK RD STE 10Dayton, OH 45414-5803

Mailing Address6551 Centerville Business Pkwy Ste 120Centerville, OH 45459-2696 · (937) 415-9100 · Fax (937) 415-9191

Phone(937) 415-9100

Fax(937) 415-9191

Sole ProprietorNo

Medical School CMSOtherGraduated 2019

Enumeration DateSeptember 12, 2019

Last NPPES UpdateDecember 4, 20222 updates tracked since enumeration

NPPES CertifiedDecember 4, 2022

✔ NPI 1114577103 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 OH · 50.006159RX

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.

4160 LITTLE YORK RD STE 10, Dayton, OH 45414

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Other Names 1

Former Name (1)Mackenzie R Rice Pa-c

Other Identifiers 1

Other50.006159RXOH · Oh Medical License

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.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 R Tiderington P.a-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 ID5698108090

PECOS Enrollment IDI20191125001735

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.

Areas of Expertise CMS Part B claims 7

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

470 services335 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

428 services286 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

35 services35 patients

Injection of trigger points, 3 or more muscles 20553

Trigger point injection therapy involves injecting medication into specific areas of your muscles, known as trigger points. These are areas that produce pain and discomfort. If you have three or more muscles affected, each will be treated individually.

27 services20 patients

X-ray of middle spine, 2 views 72070

An X-ray of the middle spine, or thoracic spine, involves capturing two different images of the area. This non-invasive procedure uses small amounts of radiation to visualize the bones and tissues in your back, helping to identify any abnormalities or injuries.

18 services17 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

14 services14 patients

Hospital Affiliations CMS Care Compare 4

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

Wilson Memorial Hospital

Acute Care Hospitals · Sidney, OH

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360013

Location915 West Michigan StreetSidney, OH 45365 · Shelby County

Emergency services Birthing friendly

Kettering Health Main Campus

Acute Care Hospitals · Kettering, OH

4/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number360079

Location3535 Southern BoulevardKettering, OH 45429 · Montgomery County

Emergency services Birthing friendly

Kettering Health Dayton

Acute Care Hospitals · Dayton, OH

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number360133

Location405 Grand AvenueDayton, OH 45405 · Montgomery County

Birthing friendly

Upper Valley Medical Center

Acute Care Hospitals · Troy, OH

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360174

Location3130 North County Road 25ATroy, OH 45373 · Miami County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 45414 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

$84.72 typical visit price

range $54.34 – $166.65

Typical copayment $21.18 (range $13.58 – $41.66)

Most-billed visit code 99203

Established Patient

$68.07 typical visit price

range $17.10 – $135.40

Typical copayment $17.01 (range $4.27 – $33.85)

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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

93.2/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Promoting Interoperability

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390

DME-Oxygen and Supplies · category DC002N

2 suppliers12 claims12 services$67.90 avg. paid by Medicare

Portable oxygen concentrator, rental E1392

DME-Oxygen and Supplies · category DC002N

2 suppliers11 claims11 services$30.88 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

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