MCKENZIE K MANGUN PA-C
NPI 1851074090
Physician Assistant in Roanoke, IL

Q: What is Mckenzie Mangun's NPI number?

The NPI number for Mckenzie Mangun is 1851074090. It was assigned to this individual provider in the NPPES registry on August 14, 2023.

Q: What is Mckenzie Mangun'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 Mckenzie Mangun was last updated on January 15, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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 August 14, 2023PECOS EnrolledAccepts Medicare Assignment

401 N MAIN ST, ROANOKE, IL 61561(309) 923-2661(309) 923-7628 Get Directions Write a Review

NPPES record last updated: January 15, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jan 15, 2026, Jan 8, 2026, Aug 14, 2023 (3 updates tracked since 2023).

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About Mckenzie K Mangun Pa-c NPPES

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

MCKENZIE K MANGUN PA-C (NPI 1851074090) is an individual physician assistant in Roanoke, Illinois, licensed in Illinois (085011710) and active in the NPI registry since August 2023. She is enrolled in Medicare PECOS, is affiliated with Saint Francis Medical Center, and is a graduate of Other (2025).

NPPES Registry Identity

NPI1851074090

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMCKENZIE K MANGUNCredential: PA-C

Location Address401 N MAIN STRoanoke, IL 61561-7585

Mailing Address401 N Main StRoanoke, IL 61561-7585 · (309) 923-2661

Phone(309) 923-2661

Fax(309) 923-7628

Sole ProprietorNo

Medical School CMSOtherGraduated 2025

Enumeration DateAugust 14, 2023

Last NPPES UpdateJanuary 15, 20263 updates tracked since enumeration

NPPES CertifiedJanuary 15, 2026

✔ NPI 1851074090 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 · 085011710

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.

401 N MAIN ST, Roanoke, IL 61561

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mckenzie K Mangun Pa-c 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.

PECOS PAC ID5496232944

PECOS Enrollment IDI20260127001645

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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Saint Francis Medical Center

Acute Care Hospitals · Peoria, IL

1/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140067

Location530 NE Glen Oak AvePeoria, IL 61637 · Peoria County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61561 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.

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.

MRS. RACHEL NICOLE ANDERSON APP

Nurse Practitioner (Family)