Timothy Andrew McKenzie, PH.D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

3389 Issued in MA

Practice address

151 Mystic Ave
Medford, MA 02155-4632

Phone

(781) 396-1199

Fax

(781) 396-1439

NPI assigned

Aug 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Boston University School of Medicine, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

DCS Mental Health, IncGroup PAC ID 8820992456, 20 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• DCS Mental Health, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Medford, MA
  • NPI 1215912894
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760598205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 WASHINGTON ST",
            "address_2": "UNIT E6",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021845727",
            "telephone_number": "781-849-1250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 MYSTIC AVE",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554632",
            "telephone_number": "781-396-1199",
            "fax_number": "781-396-1439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENZIE",
        "first_name": "TIMOTHY",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "PH.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "3389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nancy McDonald
• Phylicia McDonald
• Tyler McEachron, LCSW
• Syrah Merkow McGivern, RD
• Alicyn McHugh, PHARMD, RPH
• Deborah McLucas, PA
• Susan McNamara, LICSW
• Richard Mason McNeer III, MD
• Eliza Schwartz Meade, MD
• Lauri Day Mederios

• Psychologist in Medford, MA
• Providers in Medford, MA by specialty
• Psychologist in Massachusetts

• 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.

Verify at the official NPI Registry.