MARISA MACKENZIE
NPI 1790505873
Nurse Practitioner - Pediatrics in Portland, OR
About Marisa Mackenzie NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARISA MACKENZIE (NPI 1790505873) is an individual pediatrics provider in Portland, Oregon, licensed in Oregon (10032067) and active in the NPI registry since October 2024. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Accepted 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)
Marisa Mackenzie is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 97239 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
PORTLAND, OR 97239
PORTLAND, OR 97239
PORTLAND, OR 97239
PORTLAND, OR 97239
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 Marisa Mackenzie's NPI number?
The NPI number for Marisa Mackenzie is 1790505873. It was assigned to this individual provider in the NPPES registry on October 14, 2024.
Where is Marisa Mackenzie located?
Marisa Mackenzie practices at 3181 SW Sam Jackson Park Rd, Portland, OR 97239. The listed phone number is (503) 494-5350.
What is Marisa Mackenzie's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Pediatrics, with taxonomy code 363LP0200X.
Is Marisa Mackenzie enrolled in Medicare?
Yes. Marisa Mackenzie is registered in the Medicare PECOS enrollment system.
What insurance does Marisa Mackenzie accept?
Health plans from BridgeSpan Health Company, Moda Health Plan, Inc., Providence Health Plan and Regence BlueCross BlueShield of Oregon list Marisa Mackenzie as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Marisa Mackenzie was last updated on March 18, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.
# Marisa Mackenzie · NPI 1790505873
Pediatrics physician in Portland, Oregon. Individual provider, active in the CMS NPPES registry since October 14, 2024.
## Identity
- **NPI:** 1790505873 (Entity type: Individual)
- **Enumerated:** October 14, 2024
- **Primary specialty:** Nurse Practitioner - Pediatrics · taxonomy 363LP0200X
- **State license:** 10032067 (Oregon)
- **Sole proprietor:** No
## Practice location
- **Address:** 3181 SW SAM JACKSON PARK RD, Portland, OR 97239-3011
- **Phone:** (503) 494-5350
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
## Record status
- **NPPES last updated:** March 18, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1790505873) · Data from the CMS NPPES public registry.