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COSTNER MCKENZIE MD
NPI 1003361171
Dermatology in New York, NY

Active since August 18, 2016PECOS EnrolledAccepts Medicare Assignment
69 E 76TH ST, NEW YORK, NY 10021(800) 778-3090 Get Directions Write a Review

NPPES record last updated: March 20, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 20, 2026, Jun 24, 2021, May 4, 2020 and 1 more (4 updates tracked since 2016).

About Costner Mckenzie Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

COSTNER MCKENZIE MD (NPI 1003361171) is an individual dermatology provider in New York, New York, licensed in New York (323540) and active in the NPI registry since August 2016. He is enrolled in Medicare PECOS, maintains a secondary practice location in New York, and is a graduate of Northwestern University Feinberg Medical School (2020).

NPPES Registry Identity

NPI1003361171
Entity TypeIndividualMale
Primary Taxonomy207N00000X
Provider Legal NameCOSTNER MCKENZIECredential: MD
Location Address69 E 76TH STNew York, NY 10021-1826
Mailing Address69 E 76th StNew York, NY 10021-1826 · (800) 778-3090
Phone(800) 778-3090
Sole ProprietorNo
Medical School CMSNorthwestern University Feinberg Medical SchoolGraduated 2020
Enumeration DateAugust 18, 2016
Last NPPES UpdateMarch 20, 20264 updates tracked since enumeration
NPPES CertifiedMarch 20, 2026
✔ NPI 1003361171 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in NY · 323540
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
69 E 76TH ST, New York, NY 10021
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Secondary Practice Location 1

Location 11000 Park AveNew York, NY 10028-0934 · Phone (800) 778-3090

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Costner Mckenzie Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7810310463
PECOS Enrollment IDI20240808001816
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 10021 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$102.04 typical visit price
range $65.69 – $198.19
Typical copayment $25.51 (range $16.42 – $49.54)
Most-billed visit code 99203
Established Patient
$81.44 typical visit price
range $21.20 – $160.66
Typical copayment $20.36 (range $5.30 – $40.16)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

PARK 76 HEARING LLC
Audiologist
69 E 76TH ST
NEW YORK, NY 10021
New York County (212) 288-5038
MS. JANET P SHALLEY M.S.
Audiologist
69 E 76TH ST
NEW YORK, NY 10021
New York County (212) 288-7231
EMMANUEL R. LOUCAS, M.D., P.C.
Clinic/Center (Medical Specialty)
69 E 76TH ST
NEW YORK, NY 10021
New York County (212) 988-4357

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Costner Mckenzie's NPI number?

The NPI number for Costner Mckenzie is 1003361171. It was assigned to this individual provider in the NPPES registry on August 18, 2016.

Where is Costner Mckenzie located?

Costner Mckenzie practices at 69 E 76th St, New York, NY 10021. The listed phone number is (800) 778-3090.

What is Costner Mckenzie's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Costner Mckenzie enrolled in Medicare?

Yes. Costner Mckenzie is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Costner Mckenzie was last updated on March 20, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.