Individual provider Active NPI

Monique McKenzie

  • Family Nurse Practitioner
  • New York, NY
National Provider Identifier
1124649058
Registry record updated May 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F345303-01 Issued in NY
Practice address
1275 York Ave
New York, NY 10065-6007
Phone
(212) 639-6924
NPI assigned
May 1, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F345303-01 NY Primary

Addresses

Primary practice location

1275 York Ave
New York, NY 10065-6007

Mailing address

61 E Valley Stream Blvd
Valley Stream, NY 11580-6317

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200928002499 NY Practitioner - Nurse Practitioner 7214356096 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
75.5 of 100Reported as group
Quality
60.62
Improvement activities
40
Cost
73.87

Merit-based Incentive Payment System (MIPS)

Final score
77.91 of 100Reported as group
Quality
78.66
Improvement activities
40
Cost
48.83

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
F345303-01NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Developmental Chemo Group CurrentSince Sep 19, 2023 Accepting new patients
MSK Nassau CurrentSince Sep 6, 2024 Accepting new patients
Mskcc Surgery Group CurrentSince Sep 6, 2024 Accepting new patients
Memorial Solid Tumor Group CurrentSince Mar 1, 2020 Accepting new patients
Memorial Medical Consultation Group CurrentSince Nov 16, 2024 Accepting new patients

Locations

633 3rd Ave
Fl 4
New York, NY 10017
Phone (646) 227-3764

1275 York Ave
New York, NY 10065
Phone (212) 639-3813

1101 Hempstead Tpke
Uniondale, NY 11553
Phone (516) 559-1000

Networks

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

Interoperability endpoints

  • Direct secure messaging: mmckenzie36382@mskcc.direct-ci.com

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1588291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588896000000",
    "number": "1124649058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "61 E VALLEY STREAM BLVD",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115806317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100656007",
            "telephone_number": "212-639-6924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "MONIQUE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-01",
        "last_updated": "2020-05-08",
        "certification_date": "2020-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F345303-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.