Errol S McKenzie MD PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

222899 Issued in NY

Legal business name

ERROL S MCKENZIE MD PLLC

Practice address

212 Highbridge St
Suite C
Fayetteville, NY 13066-1981

Phone

(315) 637-0477

Fax

(315) 637-0559

NPI assigned

Jul 29, 2010

Organization subpart

No

Name

Dr. Errol McKenzie, MDNPI 1679533624

Title

Phyisician

Phone

(315) 637-0477

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Errol S McKenzie, MD

  • Family Medicine Physician
  • Fayetteville, NY
  • NPI 1679533624
  Medicare reassignment Care Compare group NPD Authorized official FAMILY MEDICINE · NY
• Chanele M Burgun, MD

  • Family Medicine Physician
  • Fayetteville, NY
  • NPI 1619954823
  Medicare reassignment Care Compare group NPD FAMILY MEDICINE · NY

• Family Medicine Associates of Fayetteville Doing business as

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Aug 24, 2010.

{
    "created_epoch": "1280361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282608000000",
    "number": "1023322286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 HIGHBRIDGE ST",
            "address_2": "SUITE C",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661981",
            "telephone_number": "315-637-0477",
            "fax_number": "315-637-0559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 HIGHBRIDGE ST",
            "address_2": "SUITE C",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661981",
            "telephone_number": "315-637-0477",
            "fax_number": "315-637-0559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERROL S MCKENZIE MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-29",
        "last_updated": "2010-08-24",
        "status": "A",
        "authorized_official_last_name": "MCKENZIE",
        "authorized_official_first_name": "ERROL",
        "authorized_official_title_or_position": "PHYISICIAN",
        "authorized_official_telephone_number": "315-637-0477",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "222899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Medicine Associates of Fayetteville",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in Fayetteville, NY
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.