DR. CLARK R MCKENZIE (MD) – Interventional Cardiology Physician, NPI 1073506051
Interventional Cardiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
205 INTERVENTIONAL CARDIOLOGY in MO
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Provider Addresses for DR. CLARK R MCKENZIE (MD)
450, North New Ballas Road, Creve Coeur, Saint Louis County, Missouri, 63141, United States
STE 270 W
SAINT LOUIS, MO 631952632
Phone: (314) 991-6969
Fax: (314) 997-6969
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 161 Open Payments records for all available years, with a total value of $4,629.
Total Amount is formed as General ($4,629) + Research ($0) + Ownership ($0) = $4,629.
Last reported payment date: 2024-12-30 • Largest payer in this snapshot: Impulse Dynamics (USA) Inc. ($1,340).
Total Amount
$4,629
General + Research + Ownership
Payments
161
Total payment records
General Amount
$4,629
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-30
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Impulse Dynamics (USA) Inc. | $1,340 |
| Edwards Lifesciences Corporation | $1,254 |
| ABIOMED | $407 |
| Shockwave Medical, Inc | $388 |
| Abbott Laboratories | $344 |
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: 2008-07-08
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20080708000020 | I | Interventional Cardiology | MO | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| Q9967 | Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml | 1,130 | 18 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 376 | 219 | $0 |
| 93458 | Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist | 129 | 127 | $0 |
| J2250 | Injection, midazolam hydrochloride, per 1 mg | 102 | 32 | $0 |
| 93000 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report | 80 | 62 | $0 |
Insurance plans in this area (ZIP 63195)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| INTERVENTIONAL CARDIOLOGY | MO | 92928 | Catheter insertion of stents in major coronary artery or branch, accessed through the skin | 48 | 34 |
| INTERVENTIONAL CARDIOLOGY | MO | 93458 | Insertion of catheter in left heart for imaging of blood vessels or grafts and left lower heart | 80 | 78 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MO | |
| Nurse Practitioner | MO | |
| Cardiovascular Disease (Cardiology) | MO | |
| - | MO | |
| Nurse Practitioner | MO | |
| Cardiovascular Disease (Cardiology) | MO | |
| - | MO | |
| Internal Medicine, Cardiac Electrophysiology, Cardiovascular Disease (Cardiology) | MO | |
| Cardiovascular Disease (Cardiology) | TX | |
| Cardiovascular Disease (Cardiology) | MO |
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