Shanice Alyssa McKenzie, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

14445 Olive View Dr
Sylmar, CA 91342-1437

Phone

(747) 210-3000

NPI assigned

Apr 5, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

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

Specialty

Dermatology

Education

University of California, Geffen School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Skin and Beauty Center IncGroup PAC ID 8628170347, 34 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Skin and Beauty Center Inc

  • Dermatology Physician
  • Burbank, CA
  • NPI 1073751129
  Medicare reassignment Care Compare group NPD
• James Y. Wang, MD, Inc.

  • Dermatology Physician
  • Los Angeles, CA
  • NPI 1538640669
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Northridge Dermatology Associates Medical Group Inc

  • Dermatology Physician
  • Northridge, CA
  • NPI 1346261617
  NPD
• Skin and Beauty Center (SBC), Inc. - Glendale

  • Dermatology Physician
  • Glendale, CA
  • NPI 1881131613
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Santa Clarita, CA
  • NPI 1316409410
  NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Panorama City, CA
  • NPI 1407888928
  NPD
• Skin and Beauty Center (SBC), Inc.

  • Dermatology Physician
  • Valencia, CA
  • NPI 1316026875
  NPD (past)
• University Dermatopathology Services Inc

  • Dermatopathology (Pathology) Physician
  • Burbank, CA
  • NPI 1376062141
  NPD (past)

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

{
    "created_epoch": "1586044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748304000000",
    "number": "1548899297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3161 S SEPULVEDA BLVD APT 208",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900344266",
            "telephone_number": "631-805-7465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14445 OLIVE VIEW DR",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "913421437",
            "telephone_number": "747-210-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "SHANICE",
        "middle_name": "ALYSSA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-05",
        "last_updated": "2025-05-27",
        "certification_date": "2020-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "13652 Cantara St",
            "city": "Panorama City",
            "state": "CA",
            "country_code": "US",
            "postal_code": "914025423",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Keith Charles McCulloch
• Saladin Rashedd McCullough II
• Mark Stanton McDonnell, MD
• Sarah McDonnell
• Erik J McEachren
• Talia Danielle McNamara, MD
• Brian McPhee, MD
• Medical Mission Adventures
• Jacqueline Medina
• Marilyn Joanna Medina

• Student in an Organized Health Care Education/Training Program in Sylmar, CA
• Providers in Sylmar, CA by specialty
• Student in an Organized Health Care Education/Training Program in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.