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

Mackenzie Faith Thompson, PA-C

Individual provider Physician Assistant · NPI 1790419174

Mackenzie Faith Thompson, PA-C is a Physician Assistant in Bloomington, Indiana. Qualified in 2024, 2 years ago. Practices with Optima Dermatology LLC, a 74-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
2
Licensed in
IN
In the registry since
2022
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Claim this listing Report a problem Suggest an edit

Practice location Address checks out

1010 W 2nd St
Bloomington, IN 47403-2217
Phone: (812) 200-2458
Fax: (930) 200-8590
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

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

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 10004876A (IN)

Record details

NPI number1790419174
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJuly 12, 2022
Last updated in NPPESJuly 10, 2025
Certification dateJuly 10, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Optima Dermatology Llc — 74 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Bloomington