Individual provider Active NPI

Mark McKenney, MD

  • Trauma Surgery Physician
  • Miami, FL
National Provider Identifier
1437212099
Registry record updated Feb 9, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Trauma Surgery PhysicianTaxonomy code 2086S0127X
License
ME57722 Issued in FL
Practice address
11760 Bird Rd
Suite 722
Miami, FL 33175-3582
Phone
(305) 559-1883
Fax
(305) 559-1887
NPI assigned
Dec 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Critical Care Physician 2086S0102X ME57722 FL
Surgery Physician 208600000X ME57722 FL
Trauma Surgery Physician 2086S0127X ME57722 FL Primary

Addresses

Primary practice location

11760 Bird Rd
Suite 722
Miami, FL 33175-3582

Mailing address

11760 Bird Rd
Suite 722
Miami, FL 33175-3582
Phone (305) 559-1883

Other identifiers 1

IdentifierTypeStateIssuer
3707504-00MedicaidFL

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address MARK.MCKENNEY@hca4.eclinicaldirectplus.com

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
I20041228000074 FL Practitioner - General Surgery 8921066747 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Michigan Medical School, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lawnwood Healthcare Specialists LLCGroup PAC ID 4789750118, 47 clinicians

Practice addresses (Care Compare)

11750 Bird Rd
Miami, FL 33175-3530
Phone (305) 559-1334

11750 SW 40 St
Miami, FL 33175-3530
Phone (305) 223-3000

2402 Frist Blvd
Fort Pierce, FL 34950-4838
Phone (772) 462-3939

Hospital & facility affiliations

  • HCA Florida Kendall Hospital Hospital, Miami, FL, CCN 100209
  • Lower Keys Medical Center Hospital, Key West, FL, CCN 100150

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME57722FLMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lawnwood Healthcare Specialists LLC CurrentSince Jul 17, 2011 Accepting new patients
Thoracic & Cardiovascular Surgeons LLC Past Accepting new patients
University of Miami Past Accepting new patients
Access Medical Group of Florida City, LLC. PastSince Aug 30, 2013 Accepting new patients

Locations

2402 Frist Blvd
Ste 204
Fort Pierce, FL 34950
Phone (772) 466-1113

11750 SW 40th St
Miami, FL 33175
Phone (305) 227-5544

11760 SW 40th St
Ste 301
Miami, FL 33175
Phone (305) 226-2020

11760 SW 40th St
Ste 722
Miami, FL 33175
Phone (305) 559-1883

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 4

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.

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": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1437212099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11760 BIRD RD",
            "address_2": "SUITE 722",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331753582",
            "telephone_number": "305-559-1883",
            "fax_number": "305-559-1887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11760 BIRD RD",
            "address_2": "SUITE 722",
            "city": "MIAMI",
            "state": "FL",
            "postal_code": "331753582",
            "telephone_number": "305-559-1883",
            "fax_number": "305-559-1887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENNEY",
        "first_name": "MARK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "FL",
            "license": "ME57722",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "FL",
            "license": "ME57722",
            "primary": false
        },
        {
            "code": "2086S0127X",
            "taxonomy_group": "",
            "desc": "Surgery, Trauma Surgery",
            "state": "FL",
            "license": "ME57722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3707504-00",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MARK.MCKENNEY@hca4.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "11760 Bird Rd",
            "address_2": "SUITE 722",
            "city": "Miami",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331753582",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Miami, FL

Sources for this page

Verify at the official NPI Registry.