MCKENZIE BROEKSTRA LSW; LMSW
NPI 1790383966
Social Worker in Gansevoort, NY
About Mckenzie Broekstra Lsw; Lmsw NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MCKENZIE BROEKSTRA LSW; LMSW (NPI 1790383966) is an individual social worker in Gansevoort, New York, licensed in Colorado (LSW.0009922840) and active in the NPI registry since October 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2019).
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
Mckenzie Broekstra Lsw; Lmsw 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 Mckenzie Broekstra reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Queensbury, NY 12804
- Reassigned Medicare billing, New York enrollment
- 107 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.
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 Broekstra's NPI number?
The NPI number for Mckenzie Broekstra is 1790383966. It was assigned to this individual provider in the NPPES registry on October 11, 2020.
Where is Mckenzie Broekstra located?
Mckenzie Broekstra practices at 6 Anyhow Ln, Gansevoort, NY 12831. The listed phone number is (616) 446-3126.
What is Mckenzie Broekstra's specialty?
The primary specialty registered for this NPI is Social Worker with taxonomy code 104100000X.
Is Mckenzie Broekstra enrolled in Medicare?
Yes. Mckenzie Broekstra 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 Mckenzie Broekstra's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mckenzie Broekstra reassigns Medicare benefits to Behavioral Health Services North, Inc. (Queensbury, NY). 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 Broekstra's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Mckenzie Broekstra was last updated on October 11, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years 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.
# Mckenzie Broekstra, LSW; LMSW · NPI 1790383966
Social Worker provider in Gansevoort, New York. Individual provider, active in the CMS NPPES registry since October 11, 2020.
## Identity
- **NPI:** 1790383966 (Entity type: Individual)
- **Enumerated:** October 11, 2020
- **Primary specialty:** Social Worker · taxonomy 104100000X
- **State license:** LSW.0009922840 (Colorado)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 6 ANYHOW LN, Gansevoort, NY 12831-1710
- **Phone:** (616) 446-3126
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Behavioral Health Services North, Inc. (NPI 1447005541, Queensbury, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2019
## Record status
- **NPPES last updated:** October 11, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1790383966) · Data from the CMS NPPES public registry.