MACKENZIE K SULLIVAN RN
NPI 1457211393
Nurse Practitioner - Psychiatric/Mental Health in Waukesha, WI

Q: What is Mackenzie Sullivan's NPI number?

The NPI number for Mackenzie Sullivan is 1457211393. It was assigned to this individual provider in the NPPES registry on November 13, 2025.

Q: What is Mackenzie Sullivan's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Active since November 13, 2025PECOS Enrolled

N20W22961 WATERTOWN RD, WAUKESHA, WI 53186(608) 495-0485 Get Directions Write a Review

NPPES record last updated: July 24, 2026. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jul 24, 2026, Jul 14, 2026, Nov 13, 2025 (3 updates tracked since 2025).

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About Mackenzie K Sullivan Rn NPPES

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

MACKENZIE K SULLIVAN RN (NPI 1457211393) is an individual psychiatric/mental health provider in Waukesha, Wisconsin, licensed in Wisconsin (18710-33) and active in the NPI registry since November 2025. She is enrolled in Medicare PECOS, maintains a secondary practice location in Poynette, and is a graduate of Other (2026).

NPPES Registry Identity

NPI1457211393

Entity TypeIndividualFemale

Primary Taxonomy363LP0808X

Provider Legal NameMACKENZIE K SULLIVANCredential: RN

Location AddressN20W22961 WATERTOWN RDWaukesha, WI 53186-1308

Mailing AddressW11095 Lake View DrLodi, WI 53555-1523 · (608) 495-0485

Phone(608) 495-0485

Sole ProprietorNo

Medical School CMSOtherGraduated 2026

Enumeration DateNovember 13, 2025

Last NPPES UpdateJuly 24, 20263 updates tracked since enumeration

NPPES CertifiedJuly 24, 2026

✔ NPI 1457211393 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in WI · 18710-33

Also ListedRegistered Nurse · Psychiatric/Mental HealthTaxonomy 163WP0808X · License 1087534 (WI)

N20W22961 WATERTOWN RD, Waukesha, WI 53186

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Secondary Practice Location 1

Location 1110 N Main StPoynette, WI 53955-9329 · Phone (608) 879-6135

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), UnitedHealthcare.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 K Sullivan Rn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9234698820

PECOS Enrollment IDI20260825000921

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 Reassignments

Medicare enrollment records show Mackenzie Sullivan reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Oak Medical Sc

Same address

Internal Medicine

N20W22961 WATERTOWN RD
Waukesha, WI 53186

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

NPI 1669910345 (262) 875-5070

Maple Medical Sc

3.0 mi

Physical Medicine & Rehabilitation

2428 N GRANDVIEW BLVD STE 102
Waukesha, WI 53188

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

NPI 1487152104 (877) 307-3226

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 53186 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.

KATELYN RYMAN NP

Nurse Practitioner