Individual provider Active NPI

Errol S McKenzie, MD

  • Family Medicine Physician
  • Fayetteville, NY
National Provider Identifier
1679533624
Registry record updated May 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
222899 Issued in NY
Practice address
212 Highbridge St Ste C
Fayetteville, NY 13066-1981
Phone
(315) 637-0477
Fax
(315) 637-0559
NPI assigned
Mar 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X N004780 NY
Family Medicine Physician 207Q00000X 222899 NY Primary

Addresses

Primary practice location

212 Highbridge St Ste C
Fayetteville, NY 13066-1981

Mailing address

212 Highbridge St Ste C
Fayetteville, NY 13066-1981
Phone (315) 637-0477

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20060818000006 NY Practitioner - Family Practice 6103829866 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Howard University College of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Errol S McKenzie MD PLLCGroup PAC ID 4880728138, 2 clinicians

Practice addresses (Care Compare)

212 Highbridge St
Suite C
Fayetteville, NY 13066-1981
Phone (315) 637-0477

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
222899NYMDFamily Medicine Physician
N004780NYMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Errol S McKenzie MD PLLC Family Medicine CurrentSince Jun 10, 2010 Accepting new patients

Locations

212 Highbridge St
Ste C
Fayetteville, NY 13066
Phone (315) 637-0477

Interoperability endpoints

  • Direct secure messaging: errol.mckenzie.1@8712.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/8712/brand/1/csg/1/fhir/r4

Organizations & group practices 1

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 4

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": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746144000000",
    "number": "1679533624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 HIGHBRIDGE ST STE C",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661981",
            "telephone_number": "315-637-0477",
            "fax_number": "315-637-0559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 HIGHBRIDGE ST STE C",
            "city": "FAYETTEVILLE",
            "state": "NY",
            "postal_code": "130661981",
            "telephone_number": "315-637-0477",
            "fax_number": "315-637-0559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "ERROL",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2025-05-02",
        "certification_date": "2025-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "NY",
            "license": "N004780",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "222899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NY

Sources for this page

Verify at the official NPI Registry.