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

Individual provider Physician Assistant · NPI 1992549984

McKenzie Gail Breault is a Physician Assistant in Philadelphia, Pennsylvania. Qualified in 2025, 1 year ago. Practices with Ladd Memorial Hospital, a 71-clinician group, works from 2 locations and accepts Medicare assignment.

Years since qualifying
1
In the registry since
2024
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Practice location Address checks out

600 S 43rd St
Philadelphia, PA 19104-4418
Phone: (715) 220-7117
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1528 Leila Ln, New Richmond, WI 54017-1083 — (715) 220-7117

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1992549984
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 24, 2024
Last updated in NPPESJuly 10, 2024
Certification dateJuly 10, 2024

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 Ladd Memorial Hospital — 71 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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