Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mackenzie Rae Ketterhagen, PA-C

Individual provider Physician Assistant · NPI 1821979519

Mackenzie Rae Ketterhagen, PA-C is a Physician Assistant in Chesterton, Indiana. Qualified in 2025, 1 year ago. Practices with Lakeshore Bone and Joint Institute, PC, a 84-clinician group, works from 4 locations and accepts Medicare assignment.

Years since qualifying
1
In the registry since
2025
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

601 Gateway Blvd N
Chesterton, IN 46304-9658
Phone: (219) 921-1444
Fax: (219) 921-5303
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (3)

  • 500 E 109th Ave, Crown Point, IN 46307-7294 — (219) 921-1444
  • 3691 Willowcreek Rd, Portage, IN 46368-5080 — (219) 921-1444
  • 833 W Lincoln Hwy Ste 110e, Schererville, IN 46375-4606 — (219) 921-1444

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X
Physician Assistant Taxonomy 363A00000X

Record details

NPI number1821979519
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedSeptember 9, 2025
Last updated in NPPESSeptember 9, 2025
Certification dateSeptember 9, 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 Lakeshore Bone And Joint Institute, Pc — 84 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Chesterton