Emmett D. McKenzie, MD

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

License

J2198 Issued in TX

Practice address

6621 Fannin St
Wt91345H
Houston, TX 77030-2303

Phone

(832) 826-5712

Fax

(832) 825-1905

NPI assigned

Oct 17, 2006

Last updated

Jul 11, 2023By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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

• Dell Children's Medical Group

  • Pediatrics Physician
  • Austin, TX
  • NPI 1326072943
  Medicare reassignment NPD
• Texas Children's Physician Group

  • Pediatrics Physician
  • Houston, TX
  • NPI 1861675506
  Medicare reassignment NPD
• Dell Children's Medical Group

  dba Dell Children's Medical Group Sleep Center

  • Sleep Disorder Diagnostic Clinic/Center
  • Austin, TX
  • NPI 1124748249
  NPD
• Baylor College of Medicine

  • Surgery Physician
  • Houston, TX
  • NPI 1225072291
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689033600000",
    "number": "1164502571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 GREENWAY PLZ",
            "address_2": "SUITE 900",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770460297",
            "telephone_number": "713-798-1750",
            "fax_number": "713-798-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6621 FANNIN ST",
            "address_2": "WT91345H",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302303",
            "telephone_number": "832-826-5712",
            "fax_number": "832-825-1905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "EMMETT",
        "middle_name": "D.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "TX",
            "license": "J2198",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "146950401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "160054727",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Annabelle Annette McKenzie, CRNA
• Bernice McKenzie, LPC
• Cornel McKenzie, APN
• Desiree McKenzie
• Emma Aura McKenzie, M.S., M.A.O.M., L.AC
• Jasmine M McKenzie, CERTIFIED HAIR LOSS
• Kevin P McKenzie, M.D.
• Kristen McKenzie
• Laurie Jane McKenzie, M.D.
• Leona McKenzie, S.L.P.

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Houston, TX
• Providers in Houston, TX by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.