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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 90 days.

MACKENZIE MOORE PA
NPI 1154244465
Physician Assistant in Fredonia, NY

Active since August 03, 2026
3780 EAGLE ST, FREDONIA, NY 14063(716) 672-3030 Get Directions Write a Review

NPPES record added: August 3, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mackenzie Moore Pa NPPES

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

MACKENZIE MOORE PA (NPI 1154244465) is an individual physician assistant in Fredonia, New York, licensed in New York (036065-01) and active in the NPI registry since August 2026. She maintains a secondary practice location in Westfield.

NPPES Registry Identity

NPI1154244465
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameMACKENZIE MOORECredential: PA
Location Address3780 EAGLE STFredonia, NY 14063-9410
Mailing Address3780 Eagle StFredonia, NY 14063-9410
Phone(716) 672-3030
Sole ProprietorNo
Enumeration DateAugust 3, 2026
NPPES CertifiedAugust 3, 2026
✔ NPI 1154244465 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 NY · 036065-01
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.
3780 EAGLE ST, Fredonia, NY 14063
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Secondary Practice Location 1

Location 1216 E Main StWestfield, NY 14787-1133 · Phone (716) 326-3240

Other Providers at the Same Location NPPES 2

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

VIVIEN LEAH REDEYE MD
Family Medicine
3780 EAGLE ST
FREDONIA, NY 14063
Chautauqua County (716) 672-3030
KAYLA E VOSS FNP
Nurse Practitioner (Primary Care)
3780 EAGLE ST
FREDONIA, NY 14063
Chautauqua County (716) 672-3030

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 Moore's NPI number?

The NPI number for Mackenzie Moore is 1154244465. It was assigned to this individual provider in the NPPES registry on August 3, 2026.

Where is Mackenzie Moore located?

Mackenzie Moore practices at 3780 Eagle St, Fredonia, NY 14063. The listed phone number is (716) 672-3030.

What is Mackenzie Moore's specialty?

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

When was this NPI record last updated?

The NPPES record for Mackenzie Moore was last updated on August 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.