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MEKENZIE SPENCER JOHNSTON KMACK CRNA
NPI 1275821316
Nurse Anesthetist, Certified Registered in Newport, OR

Active since July 11, 2011Accepts Medicare Assignment
76.82/100
CMS Quality Rating
930 SW ABBEY ST, NEWPORT, OR 97365(541) 265-2244(541) 574-1838 Get Directions Write a Review

NPPES record last updated: March 15, 2016. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Mekenzie Spencer Johnston Kmack Crna NPPES

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

MEKENZIE SPENCER JOHNSTON KMACK CRNA (NPI 1275821316) is an individual nurse anesthetist, certified registered in Newport, Oregon, licensed in Iowa (D127901) and active in the NPI registry since July 2011. She is affiliated with Willapa Harbor Hospital and is a graduate of Other (2011).

NPPES Registry Identity

NPI1275821316
Entity TypeIndividualFemale
Primary Taxonomy367500000X
Provider Legal NameMEKENZIE SPENCER JOHNSTON KMACKCredential: CRNA
Location Address930 SW ABBEY STNewport, OR 97365-4820
Mailing Address313 Se 116th StSouth Beach, OR 97366-9729 · (206) 399-3404
Phone(541) 265-2244
Fax(541) 574-1838
Sole ProprietorNo
Medical School CMSOtherGraduated 2011
Enumeration DateJuly 11, 2011
Last NPPES UpdateMarch 15, 2016
✔ NPI 1275821316 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code367500000X
License✔ Licensed in IA · D127901
Definition
(1) A licensed registered nurse with advanced specialty education in anesthesia who, in collaboration with appropriate health care professionals, provides preoperative, intraoperative, and postoperative care to patients and assists in management and resuscitation of critical patients in intensive care, coronary care, and emergency situations. Nurse anesthetists are certified following successful completion of credentials and state licensure review and a national examination directed by the Council on Certification of Nurse Anesthetists. (2) A registered nurse who is qualified by special training to administer anesthesia in collaboration with a physician or dentist and who can assist in the care of patients who are in critical condition.
930 SW ABBEY ST, Newport, OR 97365
Open in Google Maps ↗

Other Names 1

Former Name (1)Mekenzie Spencer Johnston Crna

Other Identifiers 4

OtherD-127901IA · Arnp
Medicare UPINR181055OR
Other127901IA · Rn
Medicaid500649068OR

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

Mekenzie Spencer Johnston Kmack Crna 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 ID9537339379
PECOS Enrollment IDI20150114000420

Medicare Billing Reassignments

3

Medicare enrollment records show Mekenzie Kmack reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Pacific County Hospital District 2
141 mi
Critical Access
800 ALDER ST
South Bend, WA 98586
  • Reassigned Medicare billing, Washington enrollment
  • 104 clinicians in this Medicare group
NPI 1295708683 (360) 875-5526
Public Hospital District No 2, Klickitat County Washington
147 mi
Critical Access
211 SKYLINE DRIVE
White Salmon, WA 98672
  • Reassigned Medicare billing, Washington enrollment
  • Also billed through NPI 1760455687 (Washington)
  • 85 clinicians in this Medicare group
NPI 1952483653 (509) 493-1101
Evergreen Anesthesia Associates, LLC
229 mi
Nurse Anesthetist, Certified Registered
1016 TACOMA AVE
Sunnyside, WA 98944
  • Reassigned Medicare billing, Washington enrollment
  • 42 clinicians in this Medicare group
NPI 1225575996 (509) 823-6682

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare 2

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

Willapa Harbor Hospital

Critical Access Hospitals · South Bend, WA
OwnershipGovernment - Hospital District or Authority
CMS Certification Number501303
Location800 Alder StreetSouth Bend, WA 98586 · Pacific County
Emergency services

Kittitas Valley Community Hospital

Critical Access Hospitals · Ellensburg, WA
OwnershipGovernment - Hospital District or Authority
CMS Certification Number501333
Location603 South ChestnutEllensburg, WA 98926 · Kittitas County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97365 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
$126.25 typical visit price
range $54.96 – $166.64
Typical copayment $31.56 (range $13.74 – $41.66)
Most-billed visit code 99204
Established Patient
$68.64 typical visit price
range $17.68 – $136.19
Typical copayment $17.16 (range $4.42 – $34.04)
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.

76.82/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality68.9
Improvement Activities40

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.

SAMARITAN PACIFIC HEALTH SERVICES INC
Pharmacy (Institutional Pharmacy)
930 SW ABBEY ST
NEWPORT, OR 97365
Lincoln County (541) 574-4840
DEBRA PANKIEWICZ MD
Internal Medicine
930 SW ABBEY ST
NEWPORT, OR 97365
Lincoln County (541) 265-2244
KAREN G. KOZICK RD, CDE
Nutritionist (Nutrition, Education)
930 SW ABBEY ST
NEWPORT, OR 97365
Lincoln County (541) 574-1815
CODY SHANE ALLISON BS, ACSM-CEP
Clinical Exercise Physiologist
930 SW ABBEY ST
NEWPORT, OR 97365
Lincoln County (541) 574-4856
JEAN M FREDRICKSON LCSW
Social Worker (Clinical)
930 SW ABBEY ST
NEWPORT, OR 97365
Lincoln County (541) 574-1811
MR. RICHARD KASEY CRAVEN CSFA
Technician/Technologist
930 SW ABBEY ST
NEWPORT, OR 97365
Lincoln County (541) 574-4972
SAMARITAN PACIFIC HEALTH SERVICES INC
Medicare Defined Swing Bed Unit
930 SW ABBEY ST
NEWPORT, OR 97365
Lincoln County (541) 265-2244
NICOLE JOLIN RPH
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
930 SW ABBEY ST
NEWPORT, OR 97365
Lincoln County (541) 574-4840

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 Mekenzie Kmack's NPI number?

The NPI number for Mekenzie Kmack is 1275821316. It was assigned to this individual provider in the NPPES registry on July 11, 2011. The provider is also known as Mekenzie Spencer Johnston Crna.

Where is Mekenzie Kmack located?

Mekenzie Kmack practices at 930 SW Abbey St, Newport, OR 97365. The listed phone number is (541) 265-2244.

What is Mekenzie Kmack's specialty?

The primary specialty registered for this NPI is Nurse Anesthetist, Certified Registered with taxonomy code 367500000X.

Is Mekenzie Kmack enrolled in Medicare?

Yes. Mekenzie Kmack 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 organizations bill Medicare for Mekenzie Kmack's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mekenzie Kmack reassigns Medicare benefits to 3 organizations: Pacific County Hospital District 2 (South Bend, WA), Public Hospital District No 2, Klickitat County Washington (White Salmon, WA) and Evergreen Anesthesia Associates, LLC (Sunnyside, WA). Each 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 Mekenzie Kmack's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Mekenzie Kmack affiliated with any hospitals?

According to CMS data, Mekenzie Kmack is affiliated with Willapa Harbor Hospital and Kittitas Valley Community Hospital.

When was this NPI record last updated?

The NPPES record for Mekenzie Kmack was last updated on March 15, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.