Individual provider Active NPI

Kristen Marie McKenzie, NP-C

  • Family Nurse Practitioner
  • Boston, MA
National Provider Identifier
1265613491
Registry record updated Nov 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
253092 Issued in MA
Practice address
1153 Centre St
Boston, MA 02130-3446
Phone
(617) 983-7179
NPI assigned
Nov 15, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2007

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 253092 MA Primary

Addresses

Primary practice location

1153 Centre St
Boston, MA 02130-3446

Mailing address

1153 Centre St
Boston, MA 02130-3446

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20160502000442 MA Order and Referring Only - Nurse Practitioner 9739488404

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
253092MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham and Women'S Faulkner Hospital, Inc Current Accepting new patients

Locations

1153 Centre St
Jamaica Plain, MA 02130
Phone (617) 983-7000

Interoperability endpoints

  • Direct secure messaging: mckenzie.kristen.fh@direct.partners.masshiway.net

Organizations & group practices 1

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": "1195084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195084800000",
    "number": "1265613491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1153 CENTRE ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021303446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1153 CENTRE ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021303446",
            "telephone_number": "617-983-7179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "KRISTEN",
        "middle_name": "MARIE",
        "name_prefix": "Miss",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-15",
        "last_updated": "2007-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "253092",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.