Mackenzie Carolyn Waltz Dallaire, PA-C
NPI 1164188520ActiveIndividual· Physician Assistant, Surgical· Camden, NJ
Physician Assistant, Surgical (PA-C) with Virtua Medical Group, PA, practicing in Camden, New Jersey. 33 Medicare patients in 2024, $3,812 paid; nearly all of their 63 Part D prescriptions were generic (92%). Ethicon US, LLC was the largest of 11 companies reporting payments in 2025, $900.23 in all, mostly food and beverage. Lists Virtua Our Lady of Lourdes Hospital as a hospital affiliation.
Overview
| NPI | 1164188520 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA-C |
| Sole proprietor | Yes |
| NPI issued | Nov 10, 2021 |
| Last updated in NPPES | Oct 4, 2024 |
| Certified by provider | Oct 4, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant, Surgical Primary | 363AS0400X | 25MP00728700 | NJ |
| Student in an Organized Health Care Education/Training Program | 390200000X | — | PA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (NJ) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 33 |
|---|---|
| Services billed | 56 across 6 procedure codes |
| Paid by Medicare | $3,812 |
Part D prescriptions in 2024
| Prescriptions (claims) | 63 · 67 30-day fills |
|---|---|
| Patients | 39 |
| Total drug cost | $1,016 |
| Generic share | 92% of claims |
Education and affiliations
| Graduation year | 2022 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical group
- Virtua Medical Group, PACherry Hill, NJ · 1,688 clinicians
Hospital affiliation
- Virtua Our Lady of Lourdes HospitalCamden, NJ
Industry payments (Open Payments)
- 2025$900.23 · 17 payments from 11 companies
- 2024$645.77 · 11 payments from 7 companies
Top paying companies in 2025
| Company | Amount | Payments |
|---|---|---|
| Ethicon US, LLC | $230.94 | 2 |
| Baxter Healthcare | $211.06 | 2 |
| Haemonetics Corporation | $159.44 | 1 |
| Medtronic, Inc. | $100.83 | 1 |
| Ipsen Biopharmaceuticals, Inc | $42.37 | 2 |
What the 2025 payments were for
- Food and Beverage$900.23 · 17 payments
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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