MACKENZIE ROCHON CLARK APNP
NPI 1417396524
Nurse Practitioner - Adult Health in Fitchburg, WI

Q: What is Mackenzie Clark's NPI number?

The NPI number for Mackenzie Clark is 1417396524. It was assigned to this individual provider in the NPPES registry on June 21, 2013. The provider is also known as Mackenzie Rochon Clark Apnp.

Q: What is Mackenzie Clark's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Adult Health, with taxonomy code 363LA2200X.

Q: When was this NPI record last updated?

The NPPES record for Mackenzie Clark was last updated on May 11, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.

Active since June 21, 2013PECOS Enrolled

5395 E CHERYL PKWY, FITCHBURG, WI 53711(608) 276-4660 Get Directions Write a Review

NPPES record last updated: May 11, 2023. Verified against the NPPES registry weekly; last sync: October 18, 2026.

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About Mackenzie Rochon Clark Apnp NPPES

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

MACKENZIE ROCHON CLARK APNP (NPI 1417396524) is an individual adult health provider in Fitchburg, Wisconsin, licensed in Wisconsin (4852-33) and active in the NPI registry since June 2013. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1417396524

Entity TypeIndividualFemale

Primary Taxonomy363LA2200X

Provider Legal NameMACKENZIE ROCHON CLARKCredential: APNP

Location Address5395 E CHERYL PKWYFitchburg, WI 53711-5395

Mailing Address5395 E Cheryl PkwyFitchburg, WI 53711-5395 · (608) 276-4660

Phone(608) 276-4660

Sole ProprietorNo

Enumeration DateJune 21, 2013

Last NPPES UpdateMay 11, 2023

NPPES CertifiedMay 11, 2023

✔ NPI 1417396524 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Adult HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2200X

License✔ Licensed in WI · 4852-33

Also ListedRegistered NurseTaxonomy 163W00000X · License 155942-30 (WI)

5395 E CHERYL PKWY, Fitchburg, WI 53711

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Other Names 1

Former Name (1)Mackenzie Rochon Clark Apnp

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mackenzie Rochon Clark Apnp 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.

Medicare Billing Reassignment

Medicare enrollment records show Mackenzie Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Agrace Palliative Care LLC

Same address

Hospice and Palliative Medicine

5395 E CHERYL PKWY
Fitchburg, WI 53711

Reassigned Medicare billing, Wisconsin enrollment
39 clinicians in this Medicare group

NPI 1326386129 (608) 276-4660

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 53711 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

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

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.

SAMARA ELENA WANKERL-ESTRADA CNA

Nurse's Aide