Individual provider Active NPI

Shaun Patrick McKenzie, MD

  • Surgical Oncology Physician
  • Austin, TX
National Provider Identifier
1114189933
Registry record updated Nov 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Oncology PhysicianTaxonomy code 2086X0206X
License
P6220 Issued in TX
Practice address
4101 James Casey St Ste 100
Austin, TX 78745-1145
Phone
(512) 421-4250
NPI assigned
Jul 2, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 5, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Oncology Physician 2086X0206X 43479 KY
Surgical Oncology Physician 2086X0206X P6220 TX Primary

Addresses

Primary practice location

4101 James Casey St Ste 100
Austin, TX 78745-1145

Mailing address

PO Box 911230
Dallas, TX 75391-1230
Phone (972) 997-8000

Other identifiers 5

IdentifierTypeStateIssuer
330383602MedicaidTX
330383603MedicaidTX
330383604MedicaidTX
330383605MedicaidTX
P01867717OtherTXRAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20031106000568 KY Practitioner - Surgical OncologyPractitioner - General SurgeryPractitioner - Emergency Medicine 8123931169 Reassigns benefits to 1 organization
I20131030001378 TX Practitioner - Surgical OncologyPractitioner - General Surgery 8123931169 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Surgical OncologyAlso: General Surgery
Education
Texas Tech University Health Science Center School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Texas Oncology PAGroup PAC ID 5395658934, 1,001 clinicians

Practice addresses (Care Compare)

4101 James Casey St
Suite 100
Austin, TX 78745-1145
Phone (512) 447-2202

Hospital & facility affiliations

  • St. David'S Healthcare at Home Home health agency, Austin, TX, CCN 679682
  • St David'S Medical Center Hospital, Austin, TX, CCN 450431
  • Round Rock Medical Center Hospital, Round Rock, TX, CCN 450718
  • North Austin Medical Center Hospital, Austin, TX, CCN 450809

Merit-based Incentive Payment System (MIPS)

Final score
85.12 of 100Reported as apm
Quality
67.48
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Oncology PA CurrentSince Sep 1, 2019 Accepting new patients
Surgical Associates of Austin, P.a. CurrentSince Aug 19, 2013 Accepting new patients
Lexington Surgical Specialists Surgical Oncology CurrentSince Apr 1, 2018 Accepting new patients
California Cancer Specialists Medical Group Inc Past Accepting new patients
Bluegrass Internal Medicine and Nephrology Past Accepting new patients
Bluegrass Health Psychology, Inc. PastSince Nov 22, 2020 Accepting new patients
Marshall Emergency Services Associates, PLLC Past Accepting new patients

Locations

1760 Nicholasville Rd
Ste 202
Lexington, KY 40503
Phone (859) 277-5711

6500 N Mopac Expy
Bldg 2
Austin, TX 78731
Phone (512) 343-1878

1015 E 32nd St
Ste 308
Austin, TX 78705
Phone (512) 427-2500

12221 Renfert Way
Ste 300
Austin, TX 78758
Phone (512) 873-8900

4101 James Casey St
Ste 100
Austin, TX 78745
Phone (512) 447-2202

7848 Gateway Blvd E
El Paso, TX 79915
Phone (915) 599-1313

2410 Round Rock Ave
Ste 150
Round Rock, TX 78681
Phone (512) 341-8724

Interoperability endpoints

  • Direct secure messaging: shaunmckenzie@ls.allscriptsdirect.net
  • FHIR API: https://app.meldrx.com/api/fhir/ei-bhp
  • Direct secure messaging: shaun.mckenzie@txo.ikm.direct-ci.com

Organizations & group practices 8

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.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572912000000",
    "number": "1114189933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 911230",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753911230",
            "telephone_number": "972-997-8000",
            "fax_number": "972-234-2987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 JAMES CASEY ST STE 100",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787451145",
            "telephone_number": "512-421-4250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "SHAUN",
        "middle_name": "PATRICK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-02",
        "last_updated": "2019-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "KY",
            "license": "43479",
            "primary": false
        },
        {
            "code": "2086X0206X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Oncology",
            "state": "TX",
            "license": "P6220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "330383602",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "330383603",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "330383604",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "330383605",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P01867717",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.