Active NPI
Keith Creswell McKenzie, M.D.
- Family Medicine Physician
- Clinton TWP, MI
National Provider Identifier
1801830757
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 4301067883
- Practice address
- 15501 Metropolitan Pkwy
Ste 110
Clinton TWP, MI 48036-1684 - Phone
- (586) 286-9720
- Fax
- (586) 286-3134
- NPI assigned
- Jun 15, 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 4301067883 | MI | Primary |
Addresses
Primary practice location
15501 Metropolitan Pkwy
Ste 110
Clinton TWP, MI 48036-1684
Mailing address
15501 Metropolitan Pkwy
Ste 110
Clinton TWP, MI 48036-1684
Phone (586) 286-9720
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0805013811 | Other | MI | BCBSM OF MICHIGAN |
| 352206784 | Other | MI | TAX ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Ohio State University College of Medicine, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
15501 Metropolitan Pkwy
Suite 110
Clinton Township, MI 48036-1684
Phone 5862869720126
Hospital & facility affiliations
- Henry Ford Home Health Care
- McLaren Macomb
- Henry Ford Macomb Hospital
- Beaumont Hospital, Troy
- Henry Ford Health St John Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal or shaving of skin growth | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Keith C McKenzie MD PLLC | Family Medicine | Current | Accepting new patients |
| Family Doctors | Family Medicine | Past | Accepting new patients |
Locations
15501 Metropolitan Pkwy
Ste 110
Clinton Twp, MI 48036
Phone (586) 286-9720
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/DBIFBD
- https://fhir4.healow.com/fhir/r4/DBIFBD/Endpoint/DBIFBD
- kmckenzie241754@direct.hfhs.org
Organizations & group practices 2
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.
-
- Family Medicine Physician
- Clinton TWP, MI
- NPI 1801084629
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Detroit, MI
- NPI 1932162096
-
- General Acute Care Hospital
- Clinton TWP, MI
- NPI 1023114634
-
- General Acute Care Hospital
- Warren, MI
- NPI 1902842735
-
- Psychiatric Hospital Unit
- Shelby Township, MI
- NPI 1184206385
-
- General Acute Care Hospital
- Mount Clemens, MI
- NPI 1316938327
-
- General Acute Care Hospital
- Troy, MI
- NPI 1306825997
-
- General Acute Care Hospital
- Chicago, IL
- NPI 1023088168
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515974400000",
"number": "1801830757",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15501 METROPOLITAN PKWY",
"address_2": "STE 110",
"city": "CLINTON TWP",
"state": "MI",
"postal_code": "480361684",
"telephone_number": "586-286-9720",
"fax_number": "586-286-3134"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15501 METROPOLITAN PKWY",
"address_2": "STE 110",
"city": "CLINTON TWP",
"state": "MI",
"postal_code": "480361684",
"telephone_number": "586-286-9720",
"fax_number": "586-286-3134"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCKENZIE",
"first_name": "KEITH",
"middle_name": "CRESWELL",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-06-15",
"last_updated": "2018-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "4301067883",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBSM OF MICHIGAN",
"identifier": "0805013811",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TAX ID",
"identifier": "352206784",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clinton TWP, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2018; 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.