Sandra McKenzie, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA 9109566 Issued in FL

Practice address

11905 Southern Blvd
Royal Palm Beach, FL 33411-7662

Phone

(561) 784-7852

Fax

(561) 784-7851

NPI assigned

Sep 16, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1253059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488758400000",
    "number": "1306179825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11905 SOUTHERN BLVD",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334117662",
            "telephone_number": "561-784-7852",
            "fax_number": "561-784-7851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11905 SOUTHERN BLVD",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334117662",
            "telephone_number": "561-784-7852",
            "fax_number": "561-784-7851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "SANDRA",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-16",
        "last_updated": "2017-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA 9109566",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "006748-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Simone L Matthew, RN
• Yaneth G Matute Pacheco
• Barbara Fox McAlister
• Angela McEwan
• Mary Patricia McGeary, P.T.
• Justin Hobar Dudley McKinniss
• Marcie McMaster, LCSW,CAP, CFMSW, QUA
• MD Now Medical Centers
• Md4You LLC
• Medexpress Urgent Care LLC

• Physician Assistant in Royal Palm Beach, FL
• Providers in Royal Palm Beach, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2017; 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.