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

Mackenzie Lee Carlson, PA

Individual provider Physician Assistant · NPI 1568038875

Mackenzie Lee Carlson, PA is a Physician Assistant in Edina, Minnesota. Qualified in 2021, 5 years ago. Practices with Fairview Clinics, a 806-clinician group and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
5
Licensed in
MN
In the registry since
2021
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

6565 France Ave S Ste 200
Edina, MN 55435-2141
Phone: (952) 920-2200
Fax: (952) 920-0866
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 13706 (MN)

Record details

NPI number1568038875
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorNo
NPI enumeratedMay 28, 2021
Last updated in NPPESNovember 3, 2025
Certification dateNovember 3, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Fairview Clinics — 806 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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