Costner McKenzie, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

323540 Issued in NY

Practice address

69 E 76TH St
New York, NY 10021-1826

Phone

(800) 778-3090

NPI assigned

Aug 18, 2016

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Northwestern University Feinberg Medical School, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ronald R Brancaccio MD and Peter Saitta DO PCGroup PAC ID 0648351338, 23 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

85.97 of 100Reported as group

Quality

87.04

Promoting interoperability

77

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678

Interoperability endpoints

• Direct secure messaging: cmckenzie457113@nyumc.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ronald R Brancaccio MD & Peter Saitta DO PC

  • Dermatology Physician
  • Brooklyn, NY
  • NPI 1386719425
  Medicare reassignment Care Compare group NPD
• Saitta Dermatology PC

  • Dermatology Physician
  • Brooklyn, NY
  • NPI 1083233324
  NPD (past)
• Live Beyond Medical MGMT LLC

  • Clinical Medical Laboratory
  • Delray Beach, FL
  • NPI 1386229938
  NPD (past)
• Siny Dermatology Florida

  • Dermatology Physician
  • Delray Beach, FL
  • NPI 1093565293
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1471478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773964800000",
    "number": "1003361171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 E 76TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100211826",
            "telephone_number": "800-778-3090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 E 76TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100211826",
            "telephone_number": "800-778-3090"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Park Ave",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100280934",
            "country_code": "US",
            "telephone_number": "800-778-3090",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "COSTNER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-18",
        "last_updated": "2026-03-20",
        "certification_date": "2026-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NY",
            "license": "323540",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William McKenna
• Anna Sophia McKenney, MD, PHD, MPH
• Caroll Marilyn McKenzie-Morgan, ANP/GNP
• Sara McKenzie-Vaccariello, M.S., L.AC.
• Barbara McKenzie
• Kevin Michael McKenzie, RN
• Maxin Donald McKenzie
• Maya McKenzie, LCSW
• Meghan E McKenzie, PH.D.
• Michael McKenzie, DDS

• Dermatology Physician in New York, NY
• Providers in New York, NY by specialty
• Dermatology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.