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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MACKENZIE BRONSON MD
NPI 1992408868
Pediatrics in South Lake Tahoe, CA

Active since March 22, 2023PECOS Enrolled
2201 SOUTH AVE, SOUTH LAKE TAHOE, CA 96150(530) 543-5550(530) 542-8734 Get Directions Write a Review

NPPES record last updated: September 9, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Sep 9, 2026, Mar 22, 2023 (2 updates tracked since 2023).

About Mackenzie Bronson Md NPPES

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

MACKENZIE BRONSON MD (NPI 1992408868) is an individual pediatrics provider in South Lake Tahoe, California, licensed in California (A209246) and active in the NPI registry since March 2023. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1992408868
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameMACKENZIE BRONSONCredential: MD
Location Address2201 SOUTH AVESouth Lake Tahoe, CA 96150-7025
Mailing Address2170 South AveSouth Lake Tahoe, CA 96150-7026 · (530) 541-3420
Phone(530) 543-5550
Fax(530) 542-8734
Sole ProprietorNo
Enumeration DateMarch 22, 2023
Last NPPES UpdateSeptember 9, 20262 updates tracked since enumeration
NPPES CertifiedSeptember 9, 2026
✔ NPI 1992408868 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in CA · A209246
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
2201 SOUTH AVE, South Lake Tahoe, CA 96150
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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 (PECOS)

Mackenzie Bronson Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 96150 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
$92.61 typical visit price
range $60.44 – $180.85
Typical copayment $23.15 (range $15.11 – $45.21)
Most-billed visit code 99203
Established Patient
$105.95 typical visit price
range $19.88 – $148.15
Typical copayment $26.48 (range $4.97 – $37.03)
Most-billed visit code 99214
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.

MARGARET VIEIRA
Nurse Practitioner (Family)
2201 SOUTH AVE
SOUTH LAKE TAHOE, CA 96150
El Dorado County (530) 543-5623
BARTON HEALTHCARE SYSTEM
Clinic/Center (Rural Health)
2201 SOUTH AVE
SOUTH LAKE TAHOE, CA 96150
El Dorado County (530) 543-5623
JACQUELYN NOEL SARTORIUS PA-C
Physician Assistant
2201 SOUTH AVE
SOUTH LAKE TAHOE, CA 96150
El Dorado County (530) 543-5623
DR. MATTHEW PAUL WONNACOTT MD
Family Medicine
2201 SOUTH AVE
SOUTH LAKE TAHOE, CA 96150
El Dorado County (530) 543-5623
ANNA MARIE PETERSEN FNP-BC
Nurse Practitioner (Primary Care)
2201 SOUTH AVE
SOUTH LAKE TAHOE, CA 96150
El Dorado County (530) 543-5623
CATHERINE GAEHWILER PA
Physician Assistant
2201 SOUTH AVE, STE B
SOUTH LAKE TAHOE, CA 96150
El Dorado County (530) 543-5623
DR. PAUL WILLIAM RORK MD
Family Medicine
2201 SOUTH AVE
SOUTH LAKE TAHOE, CA 96150
El Dorado County (530) 543-5623
TODD WILLIAM DEGIOVANNI PA-C
Physician Assistant
2201 SOUTH AVE
SOUTH LAKE TAHOE, CA 96150
El Dorado County (530) 543-5623

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 Mackenzie Bronson's NPI number?

The NPI number for Mackenzie Bronson is 1992408868. It was assigned to this individual provider in the NPPES registry on March 22, 2023.

Where is Mackenzie Bronson located?

Mackenzie Bronson practices at 2201 South Ave, South Lake Tahoe, CA 96150. The listed phone number is (530) 543-5550.

What is Mackenzie Bronson's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Mackenzie Bronson enrolled in Medicare?

Yes. Mackenzie Bronson is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mackenzie Bronson was last updated on September 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 days 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.