Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1154244465 Individual Practitioner Female Practitioner

Mackenzie Moore , PA

Physician Assistant • Fredonia, NY

Professional Overview & Biography Verified Profile Summary

Mackenzie Moore, PA is a registered healthcare professional specializing in Physician Assistant in Fredonia, NY. Practice services are available at 3780 EAGLE ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

3780 Eagle St

Fredonia, NY 140639410

Telephone 7166723030

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Fredonia, NY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 22.7 Yrs
State Avg: 12.0 Yrs
Regional Practice Density
6 Specialists

Practicing in Fredonia, NY (15701 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-08-03
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License NY 036065-01

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Secondary Practice Locations

216 E Main St

Westfield, NY 147871133

Phone: 7163263240

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
Dr. Vivien Redeye , MD

Family Medicine

NPI 1275820441

Doctor of Medicine (M.D.)

Kayla Voss , FNP

Nurse Practitioner - Primary Care

NPI 1790403129

Family Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active August 03, 2026

NPI status registered as active in NPPES database

📍
Updated Practice Location August 03, 2026

Registered at 3780 EAGLE ST, FREDONIA, NY 140639410 (Tel: 7166723030)

📍
Updated Business Mailing Address August 03, 2026

Registered at 3780 EAGLE ST, FREDONIA, NY 140639410

👤
Provider Name / Credentials Updated August 03, 2026

Recorded as MACKENZIE MOORE, PA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 03, 2026

Physician Assistant (License #036065-01 in NY)

🟢
Initial NPI Registration & Enumeration August 03, 2026

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1154244465
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 03, 2026
Last Update: August 03, 2026
Sole Proprietor: No

Mailing Address

3780 Eagle St

Fredonia, NY 140639410

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.