DR. CLARK R MCKENZIE MD NPI 1073506051

NPI Information

  • NPI: 1073506051
  • Provider Name: DR. CLARK R MCKENZIE, MD
  • Classification: Internal Medicine - 207RI0011X
  • Specialization: Interventional Cardiology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 450 N NEW BALLAS RD
    STE 270 W
    SAINT LOUIS, MO
    ZIP 63195
  • Phone: (314) 991-6969

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NPI Details

DR. Clark R Mckenzie, MD is an interventional cardiology internal medicine in Saint Louis, MO with 37 years of experience. The provider is an area of medicine within the subspecialty of cardiology, which uses specialized imaging and other diagnostic techniques to evaluate blood flow and pressure in the coronary arteries and chambers of the heart and uses technical procedures and medications to treat abnormalities that impair the function of the cardiovascular system. DR. Clark R Mckenzie, MD NPI is 1073506051. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF MISSOURI, KANSAS CITY, SCHOOL OF MEDICINE
Graduation Year:1989

The provider's business location address is:

450 N NEW BALLAS RD
STE 270 W
SAINT LOUIS, MO
ZIP 63195-632
Phone: (314) 991-6969
Fax: (314) 997-6969

The NPI 1073506051 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml (HCPCS:Q9967)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Injection, midazolam hydrochloride, per 1 mg (HCPCS:J2250)
  • Injection, fentanyl citrate, 0.1 mg (HCPCS:J3010)
  • Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report (HCPCS:93000)
  • Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist (HCPCS:93458)
  • Insertion of stents with balloon dilation of coronary artery or branch, single artery or branch (HCPCS:92928)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Insertion of tube in coronary artery for diagnosis with review by radiologist (HCPCS:93454)
  • Ultrasound evaluation of heart blood vessel during diagnosis or treatment, initial vessel (HCPCS:93571)
  • Insertion of tube in left lower heart chamber, coronary artery and bypass graft for diagnosis with review by radiologist (HCPCS:93459)
  • Unclassified drugs (HCPCS:J3490)
  • External shock to heart to regulate heart beat (HCPCS:92960)
  • Use of a drug to induce depression of consciousness by physician performing a procedure (5 years or older), initial 15 minutes (HCPCS:99152)
  • Insertion of tube in coronary artery for diagnosis with review by radiologist (HCPCS:93454)
  • Insertion of tube in bypass graft for diagnosis with review by radiologist (HCPCS:93455)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Replacement of aortic valve through the skin and femoral artery (HCPCS:33361)
  • Ultrasound evaluation of heart blood vessel or graft with review by radiologist, initial vessel (HCPCS:92978)
  • Removal of plaque, insertion of stent and balloon dilation of single coronary artery or branch (HCPCS:92933)
  • Coronary angioplasty and stenting (HCPCS:NAN05)
  • Pacemaker insertion or repair (HCPCS:NAN10)

The enumeration date for this NPI number is 8/25/2005 and was last updated on 1/19/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RC0000XInternal MedicineCardiovascular DiseaseR4P62MISSOURINo
2207RI0011XInternal MedicineInterventional CardiologyR4P62MISSOURIYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1006012762OTHERMEDICARE PROVIDER ID
2MA1080001OTHERMISSOURICCL INDIVDUAL PROV NUMBER
31801889795OTHERMISSOURISTL GROUP NPI
41881863009OTHERMISSOURIFARM GROUP NPI
5CD6536OTHERMISSOURIRR GROUP 01
6P00275849OTHERMISSOURIRR CCL GROUP
7CI7050OTHERMISSOURIRR GROUP 99
8000047049OTHERMISSOURIMCARE CCL GROUP NUMBER
91124011010OTHERMISSOURIHHC CATH GROUP NPI
10MA1080OTHERMISSOURICCL GROUP NUMBER
11004013185OTHERMISSOURIMEDICARE PROV ID AREA 99
12F77827MEDICARE UPINMISSOURI
13110171721OTHERMISSOURIRR MEDICARE NUMBER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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