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MCKENZIE ANDERSON DO
NPI 1457055824
Family Medicine in South Bend, IN

Active since March 29, 2023PECOS Enrolled
17321 STATE ROAD 23, SOUTH BEND, IN 46635(574) 335-8400(574) 335-0796 Get Directions Write a Review

NPPES record last updated: August 27, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Aug 27, 2026, Mar 29, 2023 (2 updates tracked since 2023).

About Mckenzie Anderson Do NPPES

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

MCKENZIE ANDERSON DO (NPI 1457055824) is an individual family medicine provider in South Bend, Indiana, licensed in Indiana (02009027A) and active in the NPI registry since March 2023. She is enrolled in Medicare PECOS and is a graduate of University Of Toledo College Of Medicine (2022).

NPPES Registry Identity

NPI1457055824
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameMCKENZIE ANDERSONCredential: DO
Location Address17321 STATE ROAD 23South Bend, IN 46635-1531
Mailing Address17321 State Road 23South Bend, IN 46635-1531 · (574) 335-8400 · Fax (574) 335-0796
Phone(574) 335-8400
Fax(574) 335-0796
Sole ProprietorNo
Medical School CMSUniversity Of Toledo College Of MedicineGraduated 2022
Enumeration DateMarch 29, 2023
Last NPPES UpdateAugust 27, 20262 updates tracked since enumeration
NPPES CertifiedAugust 27, 2026
✔ NPI 1457055824 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in IN · 02009027A
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
17321 STATE ROAD 23, South Bend, IN 46635
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mckenzie Anderson Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID42677304
PECOS Enrollment IDI20260821000226
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 Mckenzie Anderson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Saint Joseph Regional Medical Center, Inc.
6.9 mi
Family Medicine
60101 BODNAR BLVD STE 100B
Mishawaka, IN 46544
  • Reassigned Medicare billing, Indiana enrollment
  • 205 clinicians in this Medicare group
NPI 1467406074 (574) 335-8500

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 46635 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
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
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 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ROBERT HAYS M.D.
Family Medicine
17321 STATE ROAD 23
SOUTH BEND, IN 46635
St. Joseph County (574) 335-8400
ROBERT PRESTON KING M.D.
Family Medicine
17321 STATE ROAD 23
SOUTH BEND, IN 46635
St. Joseph County (574) 335-8400
DOUGLAS DEAN DOCTOR M.D.
Family Medicine
17321 STATE ROAD 23
SOUTH BEND, IN 46635
St. Joseph County (574) 335-8400
SUSAN LYNN CONN NP
Nurse Practitioner (Family)
17321 STATE ROAD 23
SOUTH BEND, IN 46635
St. Joseph County (574) 335-8400

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 Mckenzie Anderson's NPI number?

The NPI number for Mckenzie Anderson is 1457055824. It was assigned to this individual provider in the NPPES registry on March 29, 2023.

Where is Mckenzie Anderson located?

Mckenzie Anderson practices at 17321 State Road 23, South Bend, IN 46635. The listed phone number is (574) 335-8400.

What is Mckenzie Anderson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Mckenzie Anderson enrolled in Medicare?

Yes. Mckenzie Anderson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mckenzie Anderson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mckenzie Anderson reassigns Medicare benefits to Saint Joseph Regional Medical Center, Inc. (Mishawaka, IN). 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 Mckenzie Anderson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mckenzie Anderson accept?

Health plans from Anthem Blue Cross and Blue Shield and CareSource list Mckenzie Anderson 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 Mckenzie Anderson was last updated on August 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.