DR. KEITH ANDREW MACKENZIE D.O. NPI 1861498297

NPI Information

  • NPI: 1861498297
  • Provider Name: DR. KEITH ANDREW MACKENZIE, D.O.
  • Classification: Dermatology - 207NS0135X
  • Specialization: Procedural Dermatology
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3190 CLEARWATER DR
    PRESCOTT, AZ
    ZIP 86305
  • Phone: (928) 541-1312

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NPI Details

DR. Keith Andrew Mackenzie, D.O. is a procedural dermatology dermatology in Prescott, AZ with 34 years of experience. The provider is procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). DR. Keith Andrew Mackenzie, D.O. NPI is 1861498297. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Graduation Year:1991

The provider's business location address is:

3190 CLEARWATER DR
PRESCOTT, AZ
ZIP 86305-131
Phone: (928) 541-1312
Fax: (928) 541-0002

The NPI 1861498297 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.

  • Destruction of precancer skin growth, 2-14 growths (HCPCS:17003)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Destruction of precancer skin growth, 1 growth (HCPCS:17000)
  • Destruction of skin growth, 1-14 growths (HCPCS:17110)
  • Biopsy of related skin growth, first growth (HCPCS:11102)
  • Established patient office or other outpatient visit, 10-19 minutes (HCPCS:99212)
  • Superficial and/or low voltage radiation treatment delivery (HCPCS:77401)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
  • Biopsy of related skin growth, each additional growth (HCPCS:11103)
  • Removal of cancer skin growth of body, arms, or legs, 1.1-2.0 cm (HCPCS:11602)
  • Calculation of radiation therapy dose (HCPCS:77300)
  • Obtaining data needed to develop the optimal radiation treatment, 1 treatment area (HCPCS:77280)
  • Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm (HCPCS:11642)
  • Destruction of precancer skin growth, 15 or more growths (HCPCS:17004)
  • Injection into skin growth, 1-7 growths (HCPCS:11900)
  • Removal of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 0.6-1.0 cm (HCPCS:11641)
  • Obtaining data needed to develop the optimal radiation treatment, 3 or more treatment areas or any number of treatment areas where special treatment is involved (HCPCS:77290)
  • Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 1.1-2.0 cm (HCPCS:11622)
  • Intermediate repair of wound of scalp, underarms, trunk, arms, or legs, 2.6-7.5 cm (HCPCS:12032)
  • Biopsy of ear (HCPCS:69100)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Removal of skin tag, 1-15 skin tags (HCPCS:11200)
  • Intermediate repair of wound of face, ears, eyelids, nose, lips, or mouth, 2.5 cm or less (HCPCS:12051)
  • Removal of cancer skin growth of body, arms, or legs, 2.1-3.0 cm (HCPCS:11603)
  • Punch biopsy, first skin growth (HCPCS:11104)
  • Simple or single drainage of skin abscess (HCPCS:10060)
  • Destruction of cancer skin growth of face, ears, eyelids, nose, lips, or mouth, 1.1-2.0 cm (HCPCS:17282)
  • Destruction of cancer skin growth of trunk, arms, or legs, 1.1-2.0 cm (HCPCS:17262)
  • Removal of cancer skin growth of scalp, neck, hands, feet, or genitals, 0.6-1.0 cm (HCPCS:11621)
  • Biopsy of lip (HCPCS:40490)
  • Melanoma (skin cancer) excision (HCPCS:NAN03)

The enumeration date for this NPI number is 6/21/2005 and was last updated on 4/25/2012.

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
1207NS0135XDermatologyProcedural Dermatology3225ARIZONAYes

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
1G53808MEDICARE UPIN
220138MEDICARE ID-TYPE UNSPECIFIEDARIZONA
3390766MEDICAIDARIZONA

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: 3/30/2025

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