MAKENZIE DISERIO
NPI 1679146302
Physician Assistant in Dekalb, IL

Q: What is Makenzie Diserio's NPI number?

The NPI number for Makenzie Diserio is 1679146302. It was assigned to this individual provider in the NPPES registry on July 20, 2021.

Q: What is Makenzie Diserio'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 Makenzie Diserio was last updated on October 10, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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 July 20, 2021PECOS Enrolled

100/100

CMS Quality Rating

1212 S 2ND ST, DEKALB, IL 60115(872) 231-3162(702) 977-1496 Get Directions Write a Review

NPPES record last updated: October 10, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 10, 2025, Aug 15, 2022, Jul 20, 2021 (3 updates tracked since 2021).

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About Makenzie Diserio NPPES

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

MAKENZIE DISERIO (NPI 1679146302) is an individual physician assistant in Dekalb, Illinois, licensed in Illinois (085.009196) and active in the NPI registry since July 2021. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1679146302

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMAKENZIE DISERIO

Location Address1212 S 2ND STDekalb, IL 60115-4435

Mailing AddressPo Box 74008272Chicago, IL 60674-8272 · (702) 899-0595 · Fax (702) 977-1496

Phone(872) 231-3162

Fax(702) 977-1496

Sole ProprietorYes

Enumeration DateJuly 20, 2021

Last NPPES UpdateOctober 10, 20253 updates tracked since enumeration

NPPES CertifiedOctober 10, 2025

✔ NPI 1679146302 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 IL · 085.009196

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.

1212 S 2ND ST, Dekalb, IL 60115

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter Health, Ambetter Health of Delaware.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Makenzie Diserio 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.

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.

Emergency department visit with high level of medical decision making 99285

An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.

37 services36 patients

Emergency department visit with moderate level of medical decision making 99284

An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.

26 services26 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60115 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

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$68.64 typical visit price

range $17.16 – $136.56

Typical copayment $17.16 (range $4.29 – $34.14)

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.

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.

100/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

100

Improvement Activities

Cost

94.69

Other Providers at the Same Location NPPES 10

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

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