Individual provider Active NPI

Nicholas A McKenzie, MD

  • Surgery Physician
  • Pickerington, OH
National Provider Identifier
1689931206
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
35.123040 Issued in OH
Practice address
1010 Refugee Rd
Pickerington, OH 43147-9653
Phone
(614) 788-4600
NPI assigned
Apr 19, 2012
Last updated
Jan 29, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 35.123040 OH Primary
Military Health Care Provider 171000000X NU

Addresses

Primary practice location

1010 Refugee Rd
Pickerington, OH 43147-9653

Mailing address

PO Box 7527
Dublin, OH 43017-0727

Other practice location 1

3535 Pentagon Blvd
Beavercreek, OH 45431-1705
Phone (937) 702-4000

Other practice location 2

804 Central Ave
Greenville, OH 45331-1206
Phone (937) 547-0107

Other practice location 3

60 MDG/SGCS
101 Bodin Cir
Travis AFB, CA, CA 94535-1809
Phone (614) 423-5214

Electronic endpoints 4

TypeEndpointUseAffiliation
Direct Messaging Address nmckenzie707461@direct.ketteringhealth.org
FHIR URL https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/
Direct Messaging Address nmckenzie1145796@direct.ohiohealth.com Direct OhioHealth Corporation
Direct Messaging Address nmckenzie1145796@direct.ohiohealth.com Direct OhioHealth Physician Group, Inc.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20140618002224 OH Practitioner - General Surgery 4880845213 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ohiohealth CorporationGroup PAC ID 6305758426, 2,295 clinicians
Central Ohio Surgical AssociatesGroup PAC ID 6002003258, 16 clinicians
Mount Carmel Health SystemGroup PAC ID 6709793367, 84 clinicians

Practice addresses (Care Compare)

1010 Refugee Rd
Pickerington, OH 43147-9653
Phone (380) 243-3395

5350 N Meadows Dr
Grove City, OH 43123-2546
Phone (614) 228-0768

6001 E Broad St
Columbus, OH 43213-1502
Phone (614) 234-6000

6075 E Broad St
Columbus, OH 43213-5131

6484 E Main St
Reynoldsburg, OH 43068-2493
Phone (614) 864-6363

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
81.34 of 100Reported as group
Quality
63.67
Promoting interoperability
100
Improvement activities
40
Cost
74.14

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux14
Removal of tissue1-10
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ohiohealth Corporation CurrentSince Oct 1, 2024 Accepting new patients
Ohiohealth Corporation CurrentSince Oct 1, 2024 Accepting new patients
Ohiohealth Corporation Current Accepting new patients
Kettering Independent Medical Group Inc Surgery CurrentSince Dec 29, 2022 Accepting new patients
Central Ohio Surgical Associates Surgery CurrentSince Aug 15, 2024 Accepting new patients
Ohiohealth Corporation Past Accepting new patients
Mount Carmel Health System Past Accepting new patients

Locations

3535 Pentagon Blvd
Beavercreek, OH 45431
Phone (937) 702-4000

393 E Town St
Ste 116
Columbus, OH 43215
Phone (614) 566-9108

6001 E Broad St
Columbus, OH 43213
Phone (614) 224-6420

6075 E Broad St
Columbus, OH 43213
Phone (614) 759-8660

6075 E Broad St
Ste B
Columbus, OH 43213
Phone (614) 228-0768

Dept L3652
Columbus, OH 43260

725 Buckles Ct N
Ste 210
Gahanna, OH 43230
Phone (614) 245-4263

5300 N Meadows Dr
Grove City, OH 43123
Phone (614) 234-4242

5500 N Meadows Dr
Ste 210
Grove City, OH 43123
Phone (614) 228-0768

3533 Southern Blvd
Ste 2100
Kettering, OH 45429
Phone (937) 293-3486

4403 Far Hills Ave
Kettering, OH 45429
Phone (937) 395-3910

1 Prestige Pl
Ste 550
Miamisburg, OH 45342
Phone (937) 752-2306

1010 Refugee Rd
Pickerington, OH 43147
Phone (614) 587-7601

Organizations & group practices 8

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": "1334793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1689931206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7527",
            "city": "DUBLIN",
            "state": "OH",
            "postal_code": "430170727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1010 REFUGEE RD",
            "city": "PICKERINGTON",
            "state": "OH",
            "postal_code": "431479653",
            "telephone_number": "614-788-4600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3535 Pentagon Blvd",
            "address_purpose": "LOCATION",
            "city": "Beavercreek",
            "state": "OH",
            "postal_code": "454311705",
            "country_code": "US",
            "telephone_number": "937-702-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "804 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "OH",
            "postal_code": "453311206",
            "country_code": "US",
            "telephone_number": "937-547-0107",
            "fax_number": "937-547-0335",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "60 MDG/SGCS",
            "address_2": "101 Bodin Cir",
            "address_purpose": "LOCATION",
            "city": "Travis AFB, CA",
            "state": "CA",
            "postal_code": "945351809",
            "country_code": "US",
            "telephone_number": "614-423-5214",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "NICHOLAS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-19",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "OH",
            "license": "35.123040",
            "primary": true
        },
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nmckenzie707461@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "3535 Pentagon Blvd",
            "city": "Beavercreek",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454311705",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "3535 Pentagon Blvd",
            "city": "Beavercreek",
            "state": "OH",
            "country_code": "US",
            "postal_code": "454311705",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nmckenzie1145796@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Corporation",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1010 Refugee Rd",
            "city": "Pickerington",
            "state": "OH",
            "country_code": "US",
            "postal_code": "431479653",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nmckenzie1145796@direct.ohiohealth.com",
            "affiliation": "Y",
            "affiliationName": "OhioHealth Physician Group, Inc.",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1010 Refugee Rd",
            "city": "Pickerington",
            "state": "OH",
            "country_code": "US",
            "postal_code": "431479653",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pickerington, OH

Sources for this page

Verify at the official NPI Registry.