NPIMap

Individual provider Active NPI

Chad M McKenzie, D.O.

  • Vascular Surgery Physician
  • Suffolk, VA
National Provider Identifier
1114925500
Registry record updated Jan 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
0102201282 Issued in VA
Practice address
5818 Harbour View Blvd
Ste 240
Suffolk, VA 23435
Phone
(757) 397-2383
Fax
(757) 397-5201
NPI assigned
Jul 11, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 0102201282 VA Primary

Addresses

Primary practice location

5818 Harbour View Blvd
Ste 240
Suffolk, VA 23435

Mailing address

5818 Harbour View Blvd
Ste 240
Suffolk, VA 23435
Phone (757) 397-2383

Other identifiers 5

IdentifierTypeStateIssuer
89065C3OtherNCMEDICAID OF N.C.
276458OtherVAANTHEM
51895OtherVAOPTIMA
007312393MedicaidVA
770003026OtherVAMEDICARE RAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100922000850 VA Practitioner - Vascular Surgery 5597846667 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Oklahoma State University College of Osteopathic Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Commonwealth Vascular InstituteGroup PAC ID 1658542493, 4 clinicians

Practice addresses (Care Compare)

150 Burnetts Way
Suite 200
Suffolk, VA 23434-8176
Phone 7575397824508

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
97.65 of 100Reported as individual
Quality
90
Improvement activities
40
Cost
88.83

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal65
Leg revascularization (restoring blood flow)26
Removal of tissue1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Vascular Institute Vascular Surgery CurrentSince Jan 1, 2021 Accepting new patients
Maryview Hospital Past Accepting new patients

Locations

150 Burnetts Way
Ste 100B
Suffolk, VA 23434

1520 Breezeport Way
Ste 100
Suffolk, VA 23435
Phone (757) 638-1823

150 Burnetts Way
Ste 200
Suffolk, VA 23434
Phone (757) 539-7824

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DGJGDD/Endpoint/DGJGDD

Organizations & group practices 2

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 12

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": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1515974400000",
    "number": "1114925500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5818 HARBOUR VIEW BLVD",
            "address_2": "STE 240",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "23435",
            "telephone_number": "757-397-2383",
            "fax_number": "757-397-5201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5818 HARBOUR VIEW BLVD",
            "address_2": "STE 240",
            "city": "SUFFOLK",
            "state": "VA",
            "postal_code": "23435",
            "telephone_number": "757-397-2383",
            "fax_number": "757-397-5201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "CHAD",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2018-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "VA",
            "license": "0102201282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID OF N.C.",
            "identifier": "89065C3",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "276458",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPTIMA",
            "identifier": "51895",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007312393",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "770003026",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suffolk, VA

Sources for this page

Verify at the official NPI Registry.