MACKENZIE RAE KETTERHAGEN PA-C
NPI 1821979519
Physician Assistant - Surgical in Chesterton, IN
NPI Status: Active since September 09, 2025
Contact Information
601 GATEWAY BLVD N
CHESTERTON, IN
ZIP 46304
Phone: (219) 921-1444
Fax: (219) 921-5303
- Individual
- Female
- Physician Assistant
- Surgical
- PECOS Enrolled
About MACKENZIE KETTERHAGEN
This page provides the complete NPI Profile along with additional information for Mackenzie Ketterhagen, a provider established in Chesterton, Indiana with a medical specialization in Physician Assistant, focusing in surgical . The healthcare provider is registered in the NPI registry with number 1821979519 assigned on September 2025. The practitioner's primary taxonomy code is 363AS0400X. The provider is registered as an individual and her NPI record was last updated one year ago.
- NPI
- 1821979519
- Provider Name
- MACKENZIE RAE KETTERHAGEN PA-C
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 601 GATEWAY BLVD N CHESTERTON, IN 46304
- Location Phone
- (219) 921-1444
- Location Fax
- (219) 921-5303
- Mailing Address
- 601 GATEWAY BLVD N CHESTERTON, IN 46304
- Mailing Phone
- (219) 921-1444
- Mailing Fax
- (219) 921-5303
- Is Sole Proprietor?
- No
- Enumeration Date
- 09-09-2025
- Last Update Date
- 09-09-2025
- Code Navigator
Location Map
Secondary Locations
- 833 W Lincoln Hwy Ste 110E
Schererville, IN 46375
(219) 921-1444 - 500 E 109th Ave
Crown Point, IN 46307
(219) 921-1444 - 3691 Willowcreek Rd
Portage, IN 46368
(219) 921-1444
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physician Assistant Surgical
- Taxonomy Code
- 363AS0400X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 363A00000X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
Medicare Participation & PECOS Enrollment Status
Mackenzie Ketterhagen is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Reviews for MACKENZIE RAE KETTERHAGEN PA-C
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1821979519, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 71. The final step is to find the difference between that total and the next multiple of ten (80 - 71 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 71 is 80. The difference is the calculated check digit.
Other Providers at the Same Location
The following 20 providers are registered at the same or a nearby location.
CHESTERTON, IN 46304
CHESTERTON, IN 46304
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1821979519, enumerated as an "individual" on September 09, 2025.
The provider is located at 601 GATEWAY BLVD N CHESTERTON, IN 46304 and the phone number is (219) 921-1444.
Physician Assistant with taxonomy code 363AS0400X and a focus in Surgical.
