Individual provider Active NPI

Todd McKenzie, MD

  • Pediatrics Physician
  • Appleton, WI
National Provider Identifier
1528090990
Registry record updated Aug 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
43524-020 Issued in WI
Practice address
1506 S Oneida St FL 5
Appleton, WI 54915-1305
Phone
(920) 730-4950
Fax
(920) 730-5316
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 43524-020 WI Primary

Addresses

Primary practice location

1506 S Oneida St FL 5
Appleton, WI 54915-1305

Mailing address

1506 S Oneida St FL 5
Appleton, WI 54915-1305
Phone (920) 730-4950

Other identifiers 1

IdentifierTypeStateIssuer
1528090990MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20120130000782 WI Practitioner - Pediatric MedicinePractitioner - General Practice 7214194497 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
43524-020WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thedacare, Incorporated CurrentSince Dec 27, 2011 Accepting new patients
Ascension NE Wisconsin, Inc CurrentSince Jan 6, 2022 Accepting new patients
Thedacare, Incorporated CurrentSince Dec 27, 2011 Accepting new patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Jan 6, 2022 Accepting new patients
Butte Des Morts Pathology, S.C. Current Accepting new patients
Ascension NE Wisconsin, Inc CurrentSince Jan 6, 2022 Accepting new patients
Ascension Medical Group-Fox Valley Wisconsin, Inc CurrentSince Jan 6, 2022 Accepting new patients

Locations

1506 S Oneida St
Fl 5
Appleton, WI 54915
Phone (920) 730-4950

1506 S Oneida St
Appleton, WI 54915
Phone (920) 730-4950

4480 W Spencer St
Appleton, WI 54914
Phone (920) 738-4800

1501 S Madison St
Appleton, WI 54915
Phone (920) 730-4435

640 Deerwood Ave
Neenah, WI 54956
Phone (920) 727-8622

130 2nd St
Neenah, WI 54956
Phone (920) 729-2063

2700 W 9th Ave
Oshkosh, WI 54904
Phone (920) 223-0220

600 N Westhaven Dr
Oshkosh, WI 54904
Phone (920) 237-5000

Organizations & group practices 7

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": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755561600000",
    "number": "1528090990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1506 S ONEIDA ST FL 5",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549151305",
            "telephone_number": "920-730-4950",
            "fax_number": "920-730-5316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1506 S ONEIDA ST FL 5",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549151305",
            "telephone_number": "920-730-4950",
            "fax_number": "920-730-5316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "TODD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2025-08-19",
        "certification_date": "2025-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "43524-020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1528090990",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Appleton, WI

Sources for this page

Verify at the official NPI Registry.