MACKENZIE ROBERT FOUNTAIN DO
NPI 1316520166
Pediatrics in Dearborn, MI
About Mackenzie Robert Fountain Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MACKENZIE ROBERT FOUNTAIN DO (NPI 1316520166) is an individual pediatrics provider in Dearborn, Michigan, licensed in Michigan (5101027950) and active in the NPI registry since April 2021. He is enrolled in Medicare PECOS and maintains a secondary practice location in Canton.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mackenzie Robert Fountain Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Mackenzie Fountain reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Rockford, MI 49341
- Reassigned Medicare billing, Michigan enrollment
- 737 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 48124 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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 Fountain's NPI number?
The NPI number for Mackenzie Fountain is 1316520166. It was assigned to this individual provider in the NPPES registry on April 29, 2021.
Where is Mackenzie Fountain located?
Mackenzie Fountain practices at 18181 Oakwood Blvd Ste 401, Dearborn, MI 48124. The listed phone number is (313) 593-7240.
What is Mackenzie Fountain's specialty?
The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.
Is Mackenzie Fountain enrolled in Medicare?
Yes. Mackenzie Fountain is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Mackenzie Fountain's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mackenzie Fountain reassigns Medicare benefits to Advantage Health Saint Mary's Medical Group (Rockford, MI). The 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 Mackenzie Fountain's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Mackenzie Fountain accept?
Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, Oscar Insurance Company and Priority Health list Mackenzie Fountain 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.
When was this NPI record last updated?
The NPPES record for Mackenzie Fountain was last updated on August 5, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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 Robert Fountain, DO · NPI 1316520166
Pediatrics physician in Dearborn, Michigan. Individual provider, active in the CMS NPPES registry since April 29, 2021.
## Identity
- **NPI:** 1316520166 (Entity type: Individual)
- **Enumerated:** April 29, 2021
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **State license:** 5101027950 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 18181 OAKWOOD BLVD STE 401, Dearborn, MI 48124-5031
- **Phone:** (313) 593-7240 · **Fax:** (313) 593-8899
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Advantage Health Saint Mary's Medical Group (NPI 1083014914, Rockford, MI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 5, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1316520166) · Data from the CMS NPPES public registry.