Active NPI
Manuel McKenzie, M.D
- Specialist
- Bayamon, PR
National Provider Identifier
1689778037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 4417
- Practice address
- Bayamon Medical Plaza
Office 909
Bayamon, PR 00959 - Phone
- (787) 786-2230
- Fax
- (787) 786-2230
- NPI assigned
- Sep 7, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 4417 | PR | Primary |
Addresses
Primary practice location
Bayamon Medical Plaza
Office 909
Bayamon, PR 00959
Mailing address
PO Box 850
Bayamon, PR 00960-0850
Phone (787) 786-2230
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9-6539 | Other | PR | BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20131111000121 | PR | Practitioner - Obstetrics/Gynecology | 9133354624 | Practice locations: Bayamon, PR |
Care Compare profile
Medicare Care Compare- Specialty
- Obstetrics/Gynecology
- Education
- Other, 1972
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1845 Carr
2 Suite 909
Bayamon, PR 00959-7206
Phone (787) 786-2230
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4417 | PR | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1157587200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1689778037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 850",
"city": "BAYAMON",
"state": "PR",
"postal_code": "009600850",
"telephone_number": "787-786-2230",
"fax_number": "787-786-2230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BAYAMON MEDICAL PLAZA",
"address_2": "OFFICE 909",
"city": "BAYAMON",
"state": "PR",
"postal_code": "00959",
"telephone_number": "787-786-2230",
"fax_number": "787-786-2230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKENZIE",
"first_name": "MANUEL",
"name_prefix": "Mr.",
"credential": "M.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "PR",
"license": "4417",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "9-6539",
"state": "PR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bayamon, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.