Individual provider Active NPI

Corissa McKenzie, D.O.

  • Critical Care Medicine (Internal Medicine) Physician
  • Orlando, FL
National Provider Identifier
1184159410
Registry record updated Apr 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
OS16778 Issued in FL
Practice address
601 E Rollins St
Orlando, FL 32803-1248
Phone
(407) 303-7283
NPI assigned
Apr 24, 2017
Last updated
Apr 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Critical Care Medicine (Internal Medicine) Physician 207RC0200X OS16778 FL Primary

Addresses

Primary practice location

601 E Rollins St
Orlando, FL 32803-1248

Mailing address

2501 N Orange Ave Ste 401
Orlando, FL 32804-4644

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20220810003854 FL Practitioner - Critical Care (Intensivists) 9133540099 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)
Education
Alabama College of Osteopathic Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 303-2570

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
OS16778FLMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Aug 29, 2022 Accepting new patients
Florida Hospital Medical Group Inc CurrentSince Aug 29, 2022 Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

2501 N Orange Ave
Ste 401
Orlando, FL 32804

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: cmckenzie145004@adventhealth.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1492992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681862400000",
    "number": "1184159410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 N ORANGE AVE STE 401",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328044644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E ROLLINS ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031248",
            "telephone_number": "407-303-7283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "CORISSA",
        "name_prefix": "Ms.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-04-24",
        "last_updated": "2023-04-19",
        "certification_date": "2023-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "FL",
            "license": "OS16778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.