JILL J MCKENZIE (MD) – Dermatology Physician, NPI 1154513661

JILL J MCKENZIE (MD) is a healthcare provider. based in Centerville, Utah. specializing in MICROGRAPHIC DERMATOLOGIC SURGERY (MDS), DERMATOLOGY. They hold the professional credentials MD. They hold a License No. 44537 (AZ). The NPI Number for JILL J MCKENZIE (MD) is 1154513661

Main info

Female
Sole Proprietor
20 Years Of Experience
Accepts Medicare Assignment
Name
JILL J MCKENZIE (MD)
NPI
1154513661
Phone
(801) 298-3802
Address
1222 W Legacy Crossing Blvd Ste 200
Enumeration Date
17 August 2007
Last Update Date
1 March 2024

Doctor Profile

Medical School Name
UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Secondary Phone
8012983802
Graduation Year
2006 (20 years ago)
PAC ID
6103094040
Group Practice PAC ID
6507990793
Professional Enrollment ID
I20231212003732
Address ID
UT840145560CE1222XBLVD501
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience74
Completeness75
Years active:18State licenses:2Digital endpointsOther names

10 MICROGRAPHIC DERMATOLOGIC SURGERY (MDS) in UT

Provider Addresses for JILL J MCKENZIE (MD)

  • 1222 W Legacy Crossing Blvd Ste 200

    Centerville, UT 840145560

    Phone: (801) 298-3802

    Fax: (801) 298-8371

    Type: Location

  • South Dobson Road, Chandler, Maricopa County, Arizona, 85248, United States

    223

    CHANDLER, AZ 852866157

    Phone: (480) 821-8888

    Fax: (480) 821-0888

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 18 Open Payments records for all available years, with a total value of $364.

Total Amount is formed as General ($364) + Research ($0) + Ownership ($0) = $364.

Last reported payment date: 2024-11-14 • Largest payer in this snapshot: Regeneron Healthcare Solutions, Inc. ($91).

Total Amount

$364

General + Research + Ownership

Payments

18

Total payment records

General Amount

$364

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-14

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2023-12-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20110721000068IMicrographic Dermatologic Surgery (Mds)AZTBD
I20231212003732IMicrographic Dermatologic Surgery (Mds)UTTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
17311Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, 1-5 tissue blocks373307$0
17312Removal and microscopic exam of growth of head, neck, hands, feet, or genitals, each additional stage, 1-5 tissue blocks235140$0
17313Removal and microscopic exam of growth of trunk, arms, or legs, 1-5 tissue blocks158116$0
13132Complicated repair of wound of forehead, cheeks, chin, mouth, neck, underarms, genitals, hands, or feet, 2.6-7.5 cm7168$0
13121Complicated repair of wound of scalp, arms, or legs, 2.6-7.5 cm6156$0
View full utilization report →

Insurance plans in this area (ZIP 84014)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6507990793View full group profile
NameSpecialtyState
Nurse PractitionerUT
Physician AssistantUT
Physician AssistantUT
D E R M A T O L O G YUT

Reviews

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Frequently asked questions

What identifier follows JILL J MCKENZIE (MD) across health systems?
The NPI 1154513661 uniquely identifies JILL J MCKENZIE (MD) in U.S. healthcare data.
Does the public listing show JILL J MCKENZIE (MD) as active?
JILL J MCKENZIE (MD)'s NPI record reflects an active status in NPPES.
What type of care does JILL J MCKENZIE (MD) provide?
JILL J MCKENZIE (MD)'s profile centers on Dermatology Physician. Clinical services aligned with this taxonomy classification.
Is JILL J MCKENZIE (MD) tied to Centerville, Utah?
If you are local to Centerville, Utah, JILL J MCKENZIE (MD) may be relevant to your search.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.