MACKENZIE TATAR PA
NPI 1457069494
Physician Assistant in Boston, MA

Q: What is Mackenzie Tatar's NPI number?

The NPI number for Mackenzie Tatar is 1457069494. It was assigned to this individual provider in the NPPES registry on November 8, 2022. The provider is also known as Mackenzie Bonner PA.

Q: What is Mackenzie Tatar's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Mackenzie Tatar was last updated on February 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since November 08, 2022PECOS EnrolledAccepts Medicare Assignment

725 ALBANY ST STE 4B, BOSTON, MA 02118(617) 638-5633(617) 414-5226 Get Directions Write a Review

NPPES record last updated: February 19, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Dec 23, 2025, Sep 19, 2024, Nov 8, 2022 (3 updates tracked since 2022).

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About Mackenzie Tatar Pa NPPES

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

MACKENZIE TATAR PA (NPI 1457069494) is an individual physician assistant in Boston, Massachusetts, licensed in Massachusetts (PA9164) and active in the NPI registry since November 2022. She is enrolled in Medicare PECOS, is affiliated with Boston Medical Center, and maintains a secondary practice location in Dorchester.

NPPES Registry Identity

NPI1457069494

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMACKENZIE TATARCredential: PA

Location Address725 ALBANY ST STE 4BBoston, MA 02118-3549

Mailing Address960 Massachusetts Ave, Fl 2Boston, MA 02118

Phone(617) 638-5633

Fax(617) 414-5226

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateNovember 8, 2022

Last NPPES UpdateFebruary 19, 20263 updates tracked since enumeration

NPPES CertifiedFebruary 19, 2026

✔ NPI 1457069494 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in MA · PA9164

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

725 ALBANY ST STE 4B, Boston, MA 02118

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Other Names 1

Former Name (1)Mackenzie Bonner Pa

Secondary Practice Location 1

Location 139B District AveDorchester, MA 02125-1683 · Phone (617) 638-7869 · Fax (617) 638-7769

Accepted Insurance

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

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mackenzie Tatar Pa 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 ID8224486915

PECOS Enrollment IDI20240927003039

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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

68 services46 patients

Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212

This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.

24 services18 patients

Hospital Affiliations CMS Care Compare 2

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

Boston Medical Center

Acute Care Hospitals · Boston, MA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220031

Location1 Boston Medical Center PlaceBoston, MA 02118 · Suffolk County

Emergency services Birthing friendly

Signature Healthcare Brockton Hospital

Acute Care Hospitals · Brockton, MA

2/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number220052

Location680 Center StreetBrockton, MA 02302 · Plymouth County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02118 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

$97.64 typical visit price

range $63.72 – $189.86

Typical copayment $24.41 (range $15.93 – $47.46)

Most-billed visit code 99203

Established Patient

$78.84 typical visit price

range $21.07 – $155.29

Typical copayment $19.71 (range $5.26 – $38.82)

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.

Other Providers at the Same Location NPPES 13

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

RAIELLE ANDRA NOVICK

Physician Assistant