RODERICK JOHN MCKENZIE (PA-C) – Medical Physician Assistant, NPI 1134202856

RODERICK JOHN MCKENZIE (PA-C) is a healthcare provider. based in Davenport, Florida. specializing in Medical Physician Assistant. They hold the professional credentials PA-C. They hold a License No. PA1758 (FL). The NPI Number for RODERICK JOHN MCKENZIE (PA-C) is 1134202856

Main info

Male
53 Years Of Experience
Accepts Medicare Assignment
Name
RODERICK JOHN MCKENZIE (PA-C)
NPI
1134202856
Phone
(863) 422-0020
Address
141 WEB DRIVE SUITE 300
Enumeration Date
24 October 2006
Last Update Date
6 December 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5619962024
Graduation Year
1973 (53 years ago)
PAC ID
9032399241
Group Practice PAC ID
2365456811
Professional Enrollment ID
I20110204000722
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

Provider Addresses for RODERICK JOHN MCKENZIE (PA-C)

  • 141 WEB DRIVE SUITE 300

    DAVENPORT, FL 33837

    Phone: (863) 422-0020

    Fax: (863) 422-0021

    Type: Mailing

  • 1200, South Main Street, Belle Glade, Palm Beach County, Florida, 33430, United States

    SUITE 200

    BELLE GLADE, FL 334307808

    Phone: (561) 996-2024

    Fax: (561) 992-8020

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 2 Open Payments records for all available years, with a total value of $49.

Total Amount is formed as General ($49) + Research ($0) + Ownership ($0) = $49.

Last reported payment date: 2024-10-01 • Largest payer in this snapshot: Bioventus LLC ($24).

Total Amount

$49

General + Research + Ownership

Payments

2

Total payment records

General Amount

$49

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-01

Latest reported date

Top Companies

Largest payers in this snapshot

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-02-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110204000722IPhysician AssistantFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33837)

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Reviews

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Frequently asked questions

Can I verify RODERICK JOHN MCKENZIE (PA-C) with an NPI only?
You can start verification with NPI 1134202856 for RODERICK JOHN MCKENZIE (PA-C), then check state licensing separately.
Is RODERICK JOHN MCKENZIE (PA-C) still practicing?
RODERICK JOHN MCKENZIE (PA-C) is currently listed as active in the public NPI registry.
What is RODERICK JOHN MCKENZIE (PA-C)'s specialty?
The listing groups RODERICK JOHN MCKENZIE (PA-C) with Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
Where is RODERICK JOHN MCKENZIE (PA-C) based?
RODERICK JOHN MCKENZIE (PA-C) is tied to Davenport, Florida in the data we show; additional addresses may exist on the full record.
Is the information about RODERICK JOHN MCKENZIE (PA-C) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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