Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mackenzie Ann Wisniewski

Individual provider Physician Assistant · NPI 1831072735

Mackenzie Ann Wisniewski is a Physician Assistant in Myrtle Beach, South Carolina. Qualified in 2025, 1 year ago. Practices with Southeastern Hospitalist Services PC, a 307-clinician group and accepts Medicare assignment.

Years since qualifying
1
In the registry since
2025

Practice location Address checks out

809 82nd Pkwy
Myrtle Beach, SC 29572-4607
Phone: (843) 692-1000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 1235234

Record details

NPI number1831072735
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 28, 2025
Last updated in NPPESJuly 28, 2025
Certification dateJuly 28, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Southeastern Hospitalist Services Pc — 307 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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