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Physician Compare National (NPI:1104953546)

HEALTHCARE PROVIDER: JAMIE E. MCKENZIE MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1104953546
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 1052567880
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20190227002408
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name MCKENZIE
Individual professional last name
Provider First Name JAMIE
Individual professional first name
Provider Gender F
The provider's gender if the provider is a person.

Medical School Information

Medical School Name OTHER
Individual professional's medical school
Graduation Year 2009
Individual professional's medical school graduation year
Primary Specialty HEMATOLOGY/ONCOLOGY
Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1 HOSPICE/PALLIATIVE CARE
First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties HOSPICE/PALLIATIVE CARE
All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information

Organization Legal Name MAINE CENTER FOR CANCER MEDICINE AND BLOOD DISORDERS PA
Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID 0840195186
Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members 35
Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address 100 CAMPUS DR
Group Practice or individual's line 1 address
Line 2 Street Address UNIT 108
Group Practice or individual's line 2 address
City SCARBOROUGH
Group Practice or individual's city
State ME
Group Practice or individual's state
Zip Code 040747172
Group Practice or individual's zip code (9 digits when available)
Phone Number 2073033300
Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information

Hospital Affiliation CCN 1 300029
Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1 PORTSMOUTH REGIONAL HOSPITAL
Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2 200019
Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2 SOUTHERN MAINE HEALTH CARE
Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3 220171
Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3 LAHEY HOSPITAL & MEDICAL CENTER, BURLINGTON
Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4 500019
Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4 PROVIDENCE CENTRALIA HOSPITAL
Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5 200008
Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5 MERCY HOSPITAL
Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment Y

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