Individual provider Active NPI

Jeffrey A McKenna, M.D.

  • Otolaryngology Physician
  • Chandler, AZ
National Provider Identifier
1609812296
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
20965 Issued in AZ
Practice address
2081 W Frye Rd Ste 100
Chandler, AZ 85224-6278
Phone
(480) 753-1459
Fax
(480) 753-5311
NPI assigned
Jun 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 20965 AZ Primary

Addresses

Primary practice location

2081 W Frye Rd Ste 100
Chandler, AZ 85224-6278

Mailing address

9097 E Desert Cove Ave Ste 200
Scottsdale, AZ 85260-6280
Phone (480) 061-4540

Other identifiers 2

IdentifierTypeStateIssuer
152538MedicaidAZ
AZ0866580OtherAZBC PROVIDER ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20051018000005 AZ Practitioner - Otolaryngology 1759307945 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
University of Arizona College of Medicine, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Phoenix Children'S HospitalGroup PAC ID 0446278584, 431 clinicians

Practice addresses (Care Compare)

1919 E Thomas Rd
Phoenix, AZ 85016-7710
Phone (602) 933-0930

Merit-based Incentive Payment System (MIPS)

Final score
83.58 of 100Reported as group
Quality
71.49
Promoting interoperability
100
Improvement activities
40
Cost
73.79

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Phoenix Children'S Medical Group CurrentSince Apr 1, 2025 Accepting new patients
Phoenix Children'S Medical Group CurrentSince Apr 1, 2025 Accepting new patients
Phoenix Children'S Hospital Current Accepting new patients
Northern Arizona Ear Nose and Throat PC Otolaryngology PastSince Sep 1, 2001 Accepting new patients

Locations

3370 S Mercy Rd
Ste 108
Gilbert, AZ 85297

2045 S Vineyard
Ste 137
Mesa, AZ 85210

1919 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 933-0777

1920 E Cambridge Ave
Ste 201
Phoenix, AZ 85006
Phone (602) 254-5561

2108 E Thomas Rd
Ste 130
Phoenix, AZ 85016

Interoperability endpoints

  • Direct secure messaging: jeffrey.mckenna@1028.chartlogic.direct-ci.com

Organizations & group practices 5

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": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743638400000",
    "number": "1609812296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9097 E DESERT COVE AVE STE 200",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852606280",
            "telephone_number": "480-061-4540",
            "fax_number": "480-753-5311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2081 W FRYE RD STE 100",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852246278",
            "telephone_number": "480-753-1459",
            "fax_number": "480-753-5311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENNA",
        "first_name": "JEFFREY",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "AZ",
            "license": "20965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "152538",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC PROVIDER ID",
            "identifier": "AZ0866580",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

Verify at the official NPI Registry.