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

Mackenzie Moore

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1629422993

Mackenzie Moore is a General Surgery in Minneapolis, Minnesota. Graduated from University of Iowa, Rj & L Carver College of Medicine in 2016, 10 years ago. Practices with Allina Health System, a 3,867-clinician group, works from 3 locations and accepts Medicare assignment. Licensed in Minnesota.

Years since qualifying
10
Trained at
University of Iowa, Rj & L Carver College of Medicine
Licensed in
MN
In the registry since
2016
Specialties on file
2
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Practice location Address checks out

920 E 28th St Ste 460
Minneapolis, MN 55407-1286
Phone: (612) 863-7770
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 420 Delaware St Se, Minneapolis, MN 55455-0341 — (612) 625-6483
  • 3931 Louisiana Ave S, St Louis Park, MN 55426-5000 — (952) 993-3230

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence 66100 (MN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1629422993
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 22, 2016
Last updated in NPPESSeptember 7, 2023
Certification dateSeptember 7, 2023

Medicare enrollment

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

Medicare specialtyGENERAL SURGERY
Medical schoolUNIVERSITY OF IOWA, RJ & L CARVER COLLEGE OF MEDICINE
Graduated 2016 (10 years in practice)
Group practice Allina Health System — 3867 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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