MACKENZEE DERRICK AGACNP-BC
NPI 1821576406
Nurse Practitioner in Wauwatosa, WI
About Mackenzee Derrick Agacnp-bc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MACKENZEE DERRICK AGACNP-BC (NPI 1821576406) is an individual nurse practitioner in Wauwatosa, Wisconsin, licensed in Wisconsin (8553) and active in the NPI registry since August 2018. She is enrolled in Medicare PECOS, is affiliated with West Allis Memorial Hospital, and is a graduate of Other (2018).
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Other Identifiers 1
Accepted Insurance
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
Mackenzee Derrick Agacnp-bc 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 Reassignments
3Medicare enrollment records show Mackenzee Derrick reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Milwaukee, WI 53226
- Reassigned Medicare billing, Wisconsin enrollment
- 3,983 clinicians in this Medicare group
Milwaukee, WI 53209
- Reassigned Medicare billing, Wisconsin enrollment
- 1,615 clinicians in this Medicare group
Menomonee Falls, WI 53051
- Reassigned Medicare billing, Wisconsin enrollment
- 2,294 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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
West Allis Memorial Hospital
Acute Care Hospitals · West Allis, WIPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 53222 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.
WAUWATOSA, WI 53222
WAUWATOSA, WI 53222
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 Mackenzee Derrick's NPI number?
The NPI number for Mackenzee Derrick is 1821576406. It was assigned to this individual provider in the NPPES registry on August 5, 2018. The provider is also known as Mackenzee Kuczmarski Agacnp-Bc.
Where is Mackenzee Derrick located?
Mackenzee Derrick practices at 3289 N Mayfair Rd, Wauwatosa, WI 53222. The listed phone number is (414) 771-7900.
What is Mackenzee Derrick's specialty?
The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.
Is Mackenzee Derrick enrolled in Medicare?
Yes. Mackenzee Derrick 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 organizations bill Medicare for Mackenzee Derrick's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mackenzee Derrick reassigns Medicare benefits to 3 organizations: The Medical College Of Wisconsin, Inc. (Milwaukee, WI), Aurora Advanced Healthcare, Inc. (Milwaukee, WI) and Froedtert & the Medical College Of Wisconsin Community Physicians, Inc. (Menomonee Falls, WI). Each 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 Mackenzee Derrick's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Mackenzee Derrick accept?
Health plans from Anthem Blue Cross and Blue Shield, Aspirus Health Plan, CareSource (Common Ground Healthcare), HealthPartners and Network Health and 2 other insurers list Mackenzee Derrick 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.
Is Mackenzee Derrick affiliated with any hospitals?
According to CMS data, Mackenzee Derrick is affiliated with West Allis Memorial Hospital.
When was this NPI record last updated?
The NPPES record for Mackenzee Derrick was last updated on January 9, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.
# Mackenzee Derrick, AGACNP-BC · NPI 1821576406
Nurse Practitioner physician in Wauwatosa, Wisconsin. Individual provider, active in the CMS NPPES registry since August 5, 2018.
## Identity
- **NPI:** 1821576406 (Entity type: Individual)
- **Enumerated:** August 5, 2018
- **Primary specialty:** Nurse Practitioner · taxonomy 363L00000X
- **State license:** 8553 (Wisconsin)
- **Sole proprietor:** No
## Practice location
- **Address:** 3289 N MAYFAIR RD, Wauwatosa, WI 53222-3203
- **Phone:** (414) 771-7900
## 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:** 3 organizations under Medicare reassignment (form CMS-855R): The Medical College Of Wisconsin, Inc. (NPI 1699720086, Milwaukee, WI); Aurora Advanced Healthcare, Inc. (NPI 1265629133, Milwaukee, WI); Froedtert & the Medical College Of Wisconsin Community Physicians, Inc. (NPI 1568787448, Menomonee Falls, WI) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2018
## Record status
- **NPPES last updated:** January 9, 2025
- **Other identifiers:** Medicaid 100080985 (WI)
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Source: [NPI Profile](https://npiprofile.com/npi/1821576406) · Data from the CMS NPPES public registry.