MACKENZIE M MOORE
NPI 1629422993
Surgery in Minneapolis, MN
About Mackenzie M Moore NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MACKENZIE M MOORE (NPI 1629422993) is an individual surgery provider in Minneapolis, Minnesota, licensed in Minnesota (66100) and active in the NPI registry since April 2016. She is enrolled in Medicare PECOS, is affiliated with Cambridge Medical Center, and is a graduate of University Of Iowa, Rj & L Carver College Of Medicine (2016).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Mackenzie M Moore 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.
Medicare Billing Reassignment
Medicare enrollment records show Mackenzie Moore reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Minneapolis, MN 55407
- Reassigned Medicare billing, Minnesota enrollment
- 2,609 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 4
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.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Cambridge Medical Center
Acute Care Hospitals · Cambridge, MNAbbott Northwestern Hospital
Acute Care Hospitals · Minneapolis, MNPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 55407 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
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.
MINNEAPOLIS, MN 55407
MINNEAPOLIS, MN 55407
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 Mackenzie Moore's NPI number?
The NPI number for Mackenzie Moore is 1629422993. It was assigned to this individual provider in the NPPES registry on April 22, 2016.
Where is Mackenzie Moore located?
Mackenzie Moore practices at 920 E 28th St Suite 460, Minneapolis, MN 55407. The listed phone number is (612) 863-7770.
What is Mackenzie Moore's specialty?
The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.
Is Mackenzie Moore enrolled in Medicare?
Yes. Mackenzie Moore is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Mackenzie Moore's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mackenzie Moore reassigns Medicare benefits to Allina Health System (Minneapolis, MN). 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 Mackenzie Moore's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
Is Mackenzie Moore affiliated with any hospitals?
According to CMS data, Mackenzie Moore is affiliated with Cambridge Medical Center and Abbott Northwestern Hospital.
When was this NPI record last updated?
The NPPES record for Mackenzie Moore was last updated on September 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 days 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.
# Mackenzie M Moore · NPI 1629422993
Surgery physician in Minneapolis, Minnesota. Individual provider, active in the CMS NPPES registry since April 22, 2016.
## Identity
- **NPI:** 1629422993 (Entity type: Individual)
- **Enumerated:** April 22, 2016
- **Primary specialty:** Surgery · taxonomy 208600000X
- **State license:** 66100 (Minnesota)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 920 E 28TH ST, SUITE 460, Minneapolis, MN 55407-1286
- **Phone:** (612) 863-7770
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Allina Health System (NPI 1154684835, Minneapolis, MN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Iowa, Rj & L Carver College Of Medicine, class of 2016
## Record status
- **NPPES last updated:** September 29, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1629422993) · Data from the CMS NPPES public registry.