Individual provider Active NPI

Alice Jane McKinzie, DO

  • Psychiatry Physician
  • Elmira, NY
National Provider Identifier
1720025075
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
281701 Issued in NY
Practice address
600 Roe Ave
Elmira, NY 14905-1629
Phone
(607) 737-7002
Fax
(607) 271-3435
NPI assigned
Jun 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 0102207151 VA
Psychiatry Physician 2084P0800X 281701 NY Primary

Addresses

Primary practice location

600 Roe Ave
Elmira, NY 14905-1629

Mailing address

21808 Sr 54
Lutz, FL 33549

Other practice location 1

21808 Sr 54
Lutz, FL 33549
Phone (813) 428-6142

Other practice location 2

1019 E Water St
Elmira, NY 14901-3332
Phone (607) 733-5696

Other identifiers 2

IdentifierTypeStateIssuer
05336383MedicaidNY
103598538MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, FL, VA, NC, WV, MO6 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 6

Enrollment IDStateProvider typePAC IDDetails
I20181108002142 NY Practitioner - Psychiatry 7012261167 Reassigns benefits to 3 organizations
I20211115000899 FL Practitioner - Psychiatry 7012261167 Reassigns benefits to 4 organizations
I20221102001453 VA Practitioner - Psychiatry 7012261167 Reassigns benefits to 10 organizations
I20221229000367 NC Practitioner - Psychiatry 7012261167 Reassigns benefits to 2 organizations
I20240402000169 WV Practitioner - Psychiatry 7012261167 Reassigns benefits to 2 organizations
I20250313000519 MO Practitioner - Psychiatry 7012261167 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sentara Medical GroupGroup PAC ID 8921903923, 1,396 clinicians
SSM Health Care St LouisGroup PAC ID 7810800737, 171 clinicians
Winchester Medical CenterGroup PAC ID 0244134021, 313 clinicians
Nchmd IncGroup PAC ID 9436139565, 503 clinicians

Practice addresses (Care Compare)

1080 1St Colonial Rd
Suite 403
Virginia Beach, VA 23454-2406
Phone (757) 395-1850

12303 Depaul Dr
SSM Health Depaul Hospital Physician Billin
Bridgeton, MO 63044-2512
Phone (314) 344-6000

1840 Amherst St
Winchester, VA 22601-2808
Phone (540) 536-8700

3001 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6307
Phone (727) 532-1355

350 7TH St N
Naples Community Hospital
Naples, FL 34102-5754
Phone (239) 436-5100

4211 Van Dyke Rd
Lutz, FL 33558-8005
Phone (727) 532-1355

509 Biltmore Ave
Asheville, NC 28801-4601
Phone (828) 213-2325

5505 29TH Ave S
Gulfport, FL 33707-5539
Phone (757) 395-1850

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0102207151VAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Uva Community Health Medical Group, LLC CurrentSince Aug 1, 2022 Accepting new patients
Albany Medical College CurrentSince May 25, 2022 Accepting new patients
Warren Memorial Hospital, Inc. CurrentSince Feb 17, 2024 Accepting new patients
Ellis Hospital CurrentSince Mar 20, 2023 Accepting new patients
Winchester Medical Center Psychiatry Current Accepting new patients
War Memorial Hospital, Inc. CurrentSince Feb 17, 2024 Accepting new patients
CMH Physician Services, LLC Psychiatry CurrentSince Dec 1, 2022 Accepting new patients
Mission Community Anesthesiology Specialists LLC CurrentSince Oct 10, 2022 Accepting new patients
War Memorial Hospital, Inc. CurrentSince Feb 17, 2024 Accepting new patients
Uva Community Health Medical Group, LLC Psychiatry CurrentSince Aug 1, 2022 Accepting new patients
Mission Health Community Multispecialty Providers, LLC Current Accepting new patients
Sentara Medical Group CurrentSince Jan 12, 2023 Accepting new patients
Shenandoah Memorial Hospital Inc. Psychiatry CurrentSince Feb 17, 2024 Accepting new patients
Emergency Medicine Physicians of Mecklenburg County, PLLC Psychiatry CurrentSince Apr 17, 2023 Accepting new patients
Nchmd, Inc CurrentSince Mar 7, 2023 Accepting new patients
SSM Health Care St. Louis CurrentSince Jan 29, 2025 Accepting new patients
Shenandoah Memorial Hospital, Inc. CurrentSince Feb 17, 2024 Accepting new patients
CMH Physician Services, LLC CurrentSince Dec 1, 2022 Accepting new patients
Winchester Medical Center Psychiatry CurrentSince Feb 17, 2024 Accepting new patients
Nchmd Inc Current Accepting new patients
War Memorial Hospital Inc Current Accepting new patients
Mission Health Community Multispecialty Providers, LLC CurrentSince Oct 10, 2022 Accepting new patients
Family Services of Chemung County, Inc. Psychiatry CurrentSince Jan 27, 2019 Accepting new patients
Hampshire Memorial Hospital, Inc. CurrentSince Feb 17, 2024 Accepting new patients
Baycare Behavioral Health Associates LLC Psychiatry CurrentSince Nov 9, 2021 Accepting new patients
Albany Medical College CurrentSince May 25, 2022 Accepting new patients
SSM Cardinal Glennon Children'S Hospital CurrentSince Jan 29, 2025 Accepting new patients
Southside Behavioral Health Psychiatry CurrentSince Nov 15, 2023 Accepting new patients
Warren Memorial Hospital, Inc. Psychiatry CurrentSince Feb 17, 2024 Accepting new patients
Page Memorial Hospital, Inc. CurrentSince Feb 17, 2024 Accepting new patients
Landmark Hospital of Southwest Florida, LLC CurrentSince Mar 7, 2023 Accepting new patients
Albany Medical College Psychiatry CurrentSince May 25, 2022 Accepting new patients
Page Memorial Hospital, Inc. CurrentSince Feb 17, 2024 Accepting new patients
MCV Associated Physicians Psychiatry CurrentSince Oct 20, 2022 Accepting new patients
Shenandoah Memorial Hospital, Inc. Current Accepting new patients
Winchester Medical Center CurrentSince Feb 17, 2024 Accepting new patients
SSM Cardinal Glennon Childrens Hospital Psychiatry CurrentSince Jan 29, 2025 Accepting new patients
Centra Medical Group, LLC CurrentSince Jan 6, 2024 Accepting new patients
Baycare Behavioral Health Associates LLC Psychiatry CurrentSince Nov 9, 2021 Accepting new patients
SSM Health Care St Louis CurrentSince Jan 29, 2025 Accepting new patients
Hampshire Memorial Hospital, Inc. CurrentSince Feb 17, 2024 Accepting new patients
Shenandoah Memorial Hospital, Inc. Past Accepting new patients

Locations (25 of 35)

21808 State Road 54
Lutz, FL 33549
Phone (727) 315-8612

4211 Van Dyke Rd
Lutz, FL 33558
Phone (813) 265-6300

680 2nd Ave N
Ste 304
Naples, FL 34102
Phone (239) 261-7711

350 7th St N
Naples, FL 34102
Phone (239) 436-5000

6600 Madison St
New Pt Richey, FL 34652
Phone (727) 841-4611

3503 E Frontage Rd
Tampa, FL 33607
Phone (813) 586-8187

7344 Solutions Ctr
Chicago, IL 60677
Phone (314) 989-6189

1015 Bowles Ave
Fenton, MO 63026
Phone (636) 496-2000

1465 S Grand Blvd
Saint Louis, MO 63104
Phone (314) 268-4070

428 Biltmore Ave
Asheville, NC 28801
Phone (828) 213-5253

509 Biltmore Ave
Asheville, NC 28801
Phone (828) 213-2325

2001 Vail Ave
Charlotte, NC 28207
Phone (704) 304-5000

47 New Scotland Ave
Albany, NY 12208
Phone (518) 262-3773

1019 E Water St
Elmira, NY 14901
Phone (607) 733-5696

1101 Nott St
Schenectady, NY 12308
Phone (518) 243-1916

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

4105 Lewis and Clark Dr
Charlottesvle, VA 22911

140 Vista Centre Dr
Fl 2
Forest, VA 24551
Phone (434) 200-2297

351 Valley Health Way
Front Royal, VA 22630
Phone (540) 636-0300

200 Memorial Dr
Luray, VA 22835
Phone (540) 743-4561

3300 Rivermont Ave
Lynchburg, VA 24503
Phone (434) 200-4668

1901 Tate Springs Rd
Lynchburg, VA 24501
Phone (434) 200-3101

8680 Hospital Way
Manassas, VA 20110
Phone (703) 369-8055

850 Kempsville Rd
Norfolk, VA 23502
Phone (757) 261-0162

401 N 11th St
Richmond, VA 23219
Phone (804) 828-4409

Interoperability endpoints

  • Direct secure messaging: amckinzie27184@albanymed.direct-ci.com

Organizations & group practices 42

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.

View all 42

Hospital & facility affiliations 2

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1720025075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21808 SR 54",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "33549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 ROE AVE",
            "city": "ELMIRA",
            "state": "NY",
            "postal_code": "149051629",
            "telephone_number": "607-737-7002",
            "fax_number": "607-271-3435"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "21808 SR 54",
            "address_purpose": "LOCATION",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "33549",
            "country_code": "US",
            "telephone_number": "813-428-6142",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1019 E Water St",
            "address_purpose": "LOCATION",
            "city": "Elmira",
            "state": "NY",
            "postal_code": "149013332",
            "country_code": "US",
            "telephone_number": "607-733-5696",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKINZIE",
        "first_name": "ALICE",
        "middle_name": "JANE",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "VA",
            "license": "0102207151",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "281701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05336383",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "103598538",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmira, NY

Sources for this page

Verify at the official NPI Registry.