DR. MACKENZIE JUSTINE KENNESON MD
NPI 1316732027
Pediatrics in Grand Rapids, MI

Q: What is Mackenzie Kenneson's NPI number?

The NPI number for Mackenzie Kenneson is 1316732027. It was assigned to this individual provider in the NPPES registry on April 12, 2025. The provider is also known as Mackenzie Justine Olbrys.

Q: What is Mackenzie Kenneson's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Active since April 12, 2025PECOS Enrolled

275 MICHIGAN ST NE FL 8, GRAND RAPIDS, MI 49503(616) 391-8810(616) 391-8897 Get Directions Write a Review

NPPES record last updated: May 11, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 11, 2026, Jun 25, 2025, Apr 12, 2025 (3 updates tracked since 2025).

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About Dr. Mackenzie Justine Kenneson Md NPPES

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

DR. MACKENZIE JUSTINE KENNESON MD (NPI 1316732027) is an individual pediatrics provider in Grand Rapids, Michigan, licensed in Michigan (4351054776) and active in the NPI registry since April 2025. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1316732027

Entity TypeIndividualFemale

Primary Taxonomy208000000X

Provider Legal NameDR. MACKENZIE JUSTINE KENNESONCredential: MD

Location Address275 MICHIGAN ST NE FL 8Grand Rapids, MI 49503-2531

Mailing Address275 Michigan St Ne Fl 8Grand Rapids, MI 49503-2531 · (616) 391-8810 · Fax (616) 391-8897

Phone(616) 391-8810

Fax(616) 391-8897

Sole ProprietorNo

Enumeration DateApril 12, 2025

Last NPPES UpdateMay 11, 20263 updates tracked since enumeration

NPPES CertifiedMay 11, 2026

✔ NPI 1316732027 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians

Taxonomy Code208000000X

License✔ Licensed in MI · 4351054776

Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

275 MICHIGAN ST NE FL 8, Grand Rapids, MI 49503

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Other Names 1

Former Name (1)Mackenzie Justine Olbrys

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Mackenzie Justine Kenneson Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 49503 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

$84.74 typical visit price

range $54.34 – $166.68

Typical copayment $21.18 (range $13.58 – $41.67)

Most-billed visit code 99203

Established Patient

$96.44 typical visit price

range $17.09 – $135.40

Typical copayment $24.11 (range $4.27 – $33.85)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

DR. EMILY SUSAN MILLER MD

Pediatrics