MACKENZIE CAROLYN WALTZ DALLAIRE PA-C
NPI 1164188520
Physician Assistant - Surgical in Camden, NJ
About Mackenzie Carolyn Waltz Dallaire Pa-c NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MACKENZIE CAROLYN WALTZ DALLAIRE PA-C (NPI 1164188520) is an individual surgical provider in Camden, New Jersey, licensed in New Jersey (25MP00728700) and active in the NPI registry since November 2021. She is enrolled in Medicare PECOS, is affiliated with Virtua Our Lady Of Lourdes Hospital, and maintains a secondary practice location in Philadelphia.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Accepted 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 Carolyn Waltz Dallaire 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.
Areas of Expertise CMS Part B claims 2
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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Virtua Our Lady Of Lourdes Hospital
Acute Care Hospitals · Camden, NJMedicare 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.
Other Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Dallaire's NPI number?
The NPI number for Mackenzie Dallaire is 1164188520. It was assigned to this individual provider in the NPPES registry on November 10, 2021.
Where is Mackenzie Dallaire located?
Mackenzie Dallaire practices at 1601 Haddon Ave # A, Camden, NJ 08103. The listed phone number is (856) 757-3840.
What is Mackenzie Dallaire's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.
Is Mackenzie Dallaire enrolled in Medicare?
Yes. Mackenzie Dallaire 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 Dallaire accept?
Health plans from Ambetter Health and Ambetter Health of Delaware list Mackenzie Dallaire 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 Dallaire affiliated with any hospitals?
According to CMS data, Mackenzie Dallaire is affiliated with Virtua Our Lady Of Lourdes Hospital.
When was this NPI record last updated?
The NPPES record for Mackenzie Dallaire was last updated on October 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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.
# Mackenzie Carolyn Waltz Dallaire, PA-C · NPI 1164188520
Surgical physician in Camden, New Jersey. Individual provider, active in the CMS NPPES registry since November 10, 2021.
## Identity
- **NPI:** 1164188520 (Entity type: Individual)
- **Enumerated:** November 10, 2021
- **Primary specialty:** Physician Assistant - Surgical · taxonomy 363AS0400X
- **State license:** 25MP00728700 (New Jersey)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1601 HADDON AVE # A, Camden, NJ 08103-3109
- **Phone:** (856) 757-3840
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2022
## Record status
- **NPPES last updated:** October 4, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1164188520) · Data from the CMS NPPES public registry.