Individual provider Active NPI

Ian Richard McKenzie, DO

  • Anesthesiology Physician
  • Portsmouth, NH
National Provider Identifier
1326541137
Registry record updated Oct 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
22563 Issued in NH
Practice address
333 Borthwick Ave
Portsmouth, NH 03801-7128
Phone
(603) 436-5110
NPI assigned
Mar 18, 2018
Last updated
Oct 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X UO6252 FL
Anesthesiology Physician 207L00000X 22563 NH Primary

Addresses

Primary practice location

333 Borthwick Ave
Portsmouth, NH 03801-7128

Mailing address

333 Borthwick Ave
Portsmouth, NH 03801-7128
Phone (603) 436-5110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20220909002188 NH Practitioner - Anesthesiology 4183973308 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Edward Via Col of Osteo Medicine-Carolinas Campus, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Portsmouth Anesthesia Associates PAGroup PAC ID 6002855327, 40 clinicians
Stratham Anesthesia Associates PLLCGroup PAC ID 7416007950, 26 clinicians

Practice addresses (Care Compare)

333 Borthwick Ave
Portsmouth, NH 03801-7128
Phone (603) 436-5110

4 W Rd
Suite B1
Stratham, NH 03885-2612
Phone (603) 772-2076

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Stratham Anesthesia Associates PLLC Anesthesiology CurrentSince Feb 27, 2024 Accepting new patients
Portsmouth Anesthesia Associates PA Anesthesiology CurrentSince Jul 1, 2022 Accepting new patients

Locations

333 Bothwick Ave
Portsmouth, NH 03801
Phone (603) 433-4907

4 West Rd
Ste B1
Stratham, NH 03885
Phone (603) 772-2076

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": "1521331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1326541137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 BORTHWICK AVE",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017128",
            "telephone_number": "603-436-5110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 BORTHWICK AVE",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017128",
            "telephone_number": "603-436-5110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "IAN",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-18",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "UO6252",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NH",
            "license": "22563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, NH

Sources for this page

Verify at the official NPI Registry.