Individual provider Active NPI

Jana Miriam McKenzie, D.O.

  • Internal Medicine Physician
  • Saint Joseph, MO
National Provider Identifier
1629339122
Registry record updated Jan 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
DO52051 Issued in SC
Practice address
5325 Faraon St
Saint Joseph, MO 64506-3488
Phone
(816) 271-6406
NPI assigned
May 31, 2012
Last updated
Jan 6, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X DO52051 SC Primary

Addresses

Primary practice location

5325 Faraon St
Saint Joseph, MO 64506-3488

Mailing address

809 82ND Pkwy
Myrtle Beach, SC 29572-4607

Other practice location 1

102 Lyons Ave
Newark Beth Israel Medical Center
Newark, NJ 07112-2239
Phone (973) 926-7000

Other practice location 2

809 82nd Pkwy
Myrtle Beach, SC 29572
Phone (843) 692-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, MO2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150928002308 NJ Practitioner - Internal Medicine 3375851173 Reassigns benefits to 2 organizations
I20201008002372 MO Practitioner - HospitalistPractitioner - Internal Medicine 3375851173 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heartland Regional Medical CenterGroup PAC ID 6709772767, 394 clinicians

Practice addresses (Care Compare)

5325 Faraon St
Saint Joseph, MO 64506-3488
Phone (816) 271-6406

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.76 of 100Reported as group
Quality
74.35
Promoting interoperability
100
Improvement activities
40
Cost
74.85

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
DO52051SCMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ipc Hospitalist Physicians of New Jersey PC Internal Medicine CurrentSince Mar 1, 2016 Accepting new patients
Newark Beth Israel Medical Center Inc CurrentSince Aug 11, 2015 Accepting new patients
Newark Beth Israel Medical Center Inc CurrentSince Aug 11, 2015 Accepting new patients
Northwest Medical Center Association, Inc CurrentSince Dec 1, 2020 Accepting new patients
Northwest Medical Center Association Inc CurrentSince Dec 1, 2020 Accepting new patients
Mosaic Medical Center - Maryville Internal Medicine CurrentSince Jun 16, 2024 Accepting new patients
Mosaic Medical Center - Maryville CurrentSince Jun 16, 2024 Accepting new patients
Heartland Regional Medical Center Internal Medicine CurrentSince Oct 2, 2020 Accepting new patients
Ipc Hospitalist Physicians of New Jersey PC Internal Medicine CurrentSince Mar 1, 2016 Accepting new patients
Heartland Regional Medical Center CurrentSince Oct 2, 2020 Accepting new patients
Heartland Regional Medical Center Past Accepting new patients
Carriage Operator LLC Past Accepting new patients

Locations

705 N College St
Albany, MO 64402
Phone (660) 726-3941

2016 S Main St
Maryville, MO 64468
Phone (660) 562-2525

5202 Faraon St
Ste A
Saint Joseph, MO 64506
Phone (816) 271-1070

5301 Faraon St
Ste 120
Saint Joseph, MO 64506
Phone (816) 271-6406

5325 Faraon St
Saint Joseph, MO 64506
Phone (816) 271-3500

901 Heartland Rd
Ste 2800
Saint Joseph, MO 64506
Phone (816) 271-1395

151 Madison Ave
Morristown, NJ 07960
Phone (973) 656-2700

201 Lyons Ave
Newark, NJ 07112
Phone (732) 923-7455

201 Lyons Ave
#M
Newark, NJ 07112
Phone (800) 843-2384

1199 Pleasant Valley Way
West Orange, NJ 07052
Phone (973) 414-4755

Organizations & group practices 12

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 3

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": "1338422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609891200000",
    "number": "1629339122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "809 82ND PKWY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295724607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5325 FARAON ST",
            "city": "SAINT JOSEPH",
            "state": "MO",
            "postal_code": "645063488",
            "telephone_number": "816-271-6406"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "102 Lyons Ave",
            "address_2": "Newark Beth Israel Medical Center",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "NJ",
            "postal_code": "071122239",
            "country_code": "US",
            "telephone_number": "973-926-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "809 82nd Pkwy",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "29572",
            "country_code": "US",
            "telephone_number": "843-692-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "JANA",
        "middle_name": "MIRIAM",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-31",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "SC",
            "license": "DO52051",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MO

Sources for this page

Verify at the official NPI Registry.