DR. JERRY LAMONT MCKENZIE M.D.
NPI 1053679407
Family Medicine - Geriatric Medicine in Mansfield, TX

NPI Status: Active since April 23, 2012

Contact Information

1720 E BROAD ST
MANSFIELD, TX
ZIP 76063
Phone: (817) 453-5912

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  • Individual
  • Male
  • Years of Experience 14
  • Family Medicine
  • Geriatric Medicine
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About JERRY MCKENZIE

This page provides the complete NPI Profile along with additional information for Jerry Mckenzie, a primary care provider established in Mansfield, Texas with a medical specialization in Family Medicine, focusing in geriatric medicine and more than 14 years of experience. He graduated from University Of Arkansas College Of Medicine in 2012. The healthcare provider is registered in the NPI registry with number 1053679407 assigned on April 2012. The practitioner's primary taxonomy code is 207QG0300X with license number R4786 (TX). The provider is registered as an individual and his NPI record was last updated 2 years ago.

NPI
1053679407
Provider Name
DR. JERRY LAMONT MCKENZIE M.D.
Gender
Male
Entity Type
Individual
Location Address
1720 E BROAD ST MANSFIELD, TX 76063
Location Phone
(817) 453-5912
Mailing Address
4400 OAK PARK LN FORT WORTH, TX 76109
Mailing Phone
(817) 985-7772
Medical School Name
UNIVERSITY OF ARKANSAS COLLEGE OF MEDICINE
Graduation Year
2012
Is Sole Proprietor?
No
Enumeration Date
04-23-2012
Last Update Date
12-11-2024
Code Navigator

A primary care provider (PCP) like Jerry Mckenzie sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Location Map

Secondary Locations

  • 845 Desco Ln
    Grand Prairie, TX 75051
    (817) 761-7876
  • 3920 W Wheatland Rd Ste 152
    Dallas, TX 75237
    (214) 467-0432

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Family Medicine Geriatric Medicine

Taxonomy Code
207QG0300X
Type
Allopathic & Osteopathic Physicians
License No.
R4786
License State
TX
Taxonomy Description
A family medicine physician with special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes, and the hospital.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1207P00000XAllopathic & Osteopathic Physicians

Emergency Medicine

E-8969 (AR)
2390200000XStudent, Health Care

Student in an Organized Health Care Education/Training Program

 

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Choice Bronze HSA - HMO
  • Choice Bronze HSA + Vision + Adult Dental - HMO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Complete Silver - HMO
  • Complete Silver + Vision + Adult Dental - HMO
  • Elite Gold - HMO
  • Elite Gold + Vision + Adult Dental - HMO
  • Everyday Bronze - HMO
  • Everyday Bronze + Vision + Adult Dental - HMO
  • Standard Expanded Bronze - HMO
  • Standard Expanded Bronze + Vision + Adult Dental - HMO
  • Standard Gold - HMO
  • Standard Gold + Vision + Adult Dental - HMO
  • Standard Silver - HMO
  • Standard Silver + Vision + Adult Dental - HMO
  • Choice Bronze HSA (QualChoice) - POS
  • Complete Gold - PPO
  • Complete Gold + Vision + Adult Dental - PPO
  • Connected Silver - PPO
  • Connected Silver (QualChoice) - POS
  • Connected Silver (QualChoice) + Vision + Adult Dental - POS
  • Connected Silver (QualChoiceLife) - PPO
  • Connected Silver (QualChoiceLife) + Vision + Adult Dental - PPO
  • Connected Silver + Vision + Adult Dental - PPO
  • Elite Bronze - PPO
  • Elite Bronze + Vision + Adult Dental - PPO
  • Elite Gold (QualChoice) - POS
  • Elite Gold (QualChoice) + Vision + Adult Dental - POS
  • Elite Gold (QualChoiceLife) - PPO
  • Elite Gold (QualChoiceLife) + Vision + Adult Dental - PPO
  • Everyday Bronze - PPO
  • Everyday Bronze + Vision + Adult Dental - PPO
  • Standard Expanded Bronze - PPO
  • Standard Expanded Bronze (QualChoice) - POS
  • Standard Expanded Bronze + Vision + Adult Dental - PPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Standard Expanded Bronze - EPO
  • Standard Expanded Bronze + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - EPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Standard Gold - EPO
  • Standard Gold + Vision + Adult Dental - EPO
  • Standard Silver - EPO
  • Standard Silver + Vision + Adult Dental - EPO
  • Elite Bronze - PPO
  • Elite Bronze + Vision + Adult Dental - PPO
  • Elite Gold - PPO
  • Elite Gold + Vision + Adult Dental - PPO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options - PPO
  • Enhanced Asthma/COPD Care Silver with $0 Drug Options + Vision + Adult Dental - PPO
  • Enhanced Diabetes Care Silver with $0 Drug Options - PPO
  • Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - PPO
  • Everyday Bronze - PPO
  • Everyday Bronze + Vision + Adult Dental - PPO
  • Everyday Gold - PPO
  • Everyday Gold + Vision + Adult Dental - PPO
  • Focused Silver - PPO
  • Focused Silver + Vision + Adult Dental - PPO
  • Standard Expanded Bronze - PPO
  • Standard Expanded Bronze + Vision + Adult Dental - PPO
  • Standard Gold - PPO
  • Standard Gold + Vision + Adult Dental - PPO
  • Standard Silver - PPO
  • Standard Silver + Vision + Adult Dental - PPO
  • AvMed Entrust Bronze 600 (2026) - HMO
  • AvMed Entrust Bronze 650 (2026) - HMO
  • AvMed Entrust Expanded Bronze Standard (2026) - HMO
  • AvMed Entrust Gold 125 (2026) - HMO
  • AvMed Entrust Gold 125 Dental+Vision (2026) - HMO
  • AvMed Entrust Gold Standard (2026) - HMO
  • AvMed Entrust Platinum 25 (2026) - HMO
  • AvMed Entrust Platinum 25 Dental+Vision (2026) - HMO
  • AvMed Entrust Platinum Standard (2026) - HMO
  • AvMed Entrust Silver 350 (2026) - HMO
  • AvMed Entrust Silver 350 Dental+Vision (2026) - HMO
  • AvMed Entrust Silver 550 (2026) - HMO
  • AvMed Entrust Silver 550 Dental+Vision (2026) - HMO
  • AvMed Entrust Silver Standard (2026) - HMO
  • BSW Diabetes Care Gold HMO 014 - HMO
  • BSW Elite Gold HMO 001 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
  • BSW Elite Gold HMO 004 - HMO
  • BSW Elite Gold HMO 012 - HMO
  • BSW Prime Silver HMO 003 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
  • BSW Prime Silver HMO 008 - HMO
  • BSW Prime Silver HMO 005 - HMO
  • BSW Savers Bronze HMO H S A 006 - HMO
  • BSW Savers Bronze HMO H S A 007 (CMS Standardized Plan with $0 Pediatric PCP copay) - HMO
  • BSW Savers Bronze HMO H S A 009 - HMO
  • Blue Advantage Bronze HMO? 204 - HMO
  • Blue Advantage Bronze HMO? 301 - HMO
  • Blue Advantage Bronze HMO? Standard - HMO
  • Blue Advantage Gold HMO? 206 - HMO
  • Blue Advantage Gold HMO? 603 - HMO
  • Blue Advantage Gold HMO? Standard - HMO
  • Blue Advantage Plus Bronze? 303 - POS
  • Blue Advantage Plus Bronze? 305 - POS
  • Blue Advantage Plus Bronze? Standard - POS
  • Blue Advantage Plus Gold? 203 - POS
  • Blue Advantage Plus Gold? 803 - POS
  • Blue Advantage Plus Gold? Standard - POS
  • Blue Advantage Plus Silver? 202 - POS
  • Blue Advantage Plus Silver? 605 - POS
  • Blue Advantage Plus Silver? Standard - POS
  • Blue Advantage Security HMO? 200 - HMO
  • Blue Advantage Silver HMO? 205 - HMO
  • Blue Advantage Silver HMO? 801 - HMO
  • Blue Advantage Silver HMO? Standard - HMO
  • MyBlue Health Bronze? 402 - HMO
  • Molina Gold Core 1640 - HMO
  • Molina Gold Core 1640 Plus with Adult Dental and Vision - HMO
  • Molina Gold Core 1640 Plus with Adult Vision - HMO
  • Molina Gold Saver 750 - HMO
  • Molina Gold Saver 750 Plus with Adult Dental and Vision - HMO
  • Molina Gold Saver 750 Plus with Adult Vision - HMO
  • Molina Gold Standard - HMO
  • Molina Silver Core - HMO
  • Molina Silver Core Plus with Adult Dental and Vision - HMO
  • Molina Silver Core Plus with Adult Vision - HMO
  • Molina Silver Saver with Four Free PCP Visits - HMO
  • Molina Silver Standard - HMO
  • Bronze Classic 4700 - EPO
  • Bronze Classic Standard - EPO
  • Bronze Elite + PCP Saver Plus - EPO
  • Bronze Simple Breathe Easy with Enhanced COPD Benefits - EPO
  • Bronze Simple Chronic Care CKM - EPO
  • Bronze Simple Diabetes - EPO
  • Gold Classic - EPO
  • Gold Classic Guided Care - HMO
  • Gold Classic Standard - EPO
  • Gold Classic Standard Guided Care - HMO
  • Gold Elite - EPO
  • Gold Simple Diabetes Guided Care - HMO
  • Gold Simple Guided Care - HMO
  • Silver Classic - EPO
  • Silver Classic Standard - EPO
  • Silver Classic Standard Guided Care - HMO
  • Silver Simple Breathe Easy with Enhanced COPD Benefits Guided Care - HMO
  • Silver Simple Chronic Care CKM Guided Care - HMO
  • Silver Simple Diabetes Guided Care - HMO
  • Silver Simple Guided Care - HMO
  • Wellpoint Essential Bronze 4000 HSA (+ Incentives) - HMO
  • Wellpoint Essential Bronze 6000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Bronze 6000 Adult Dental/Vision ($0 Virtual PCP+$0 Select Drugs) - HMO
  • Wellpoint Essential Bronze 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Bronze POS 4500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Wellpoint Essential Bronze POS 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Wellpoint Essential Bronze POS 7500 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Wellpoint Essential Catastrophic (+ Incentives) - HMO
  • Wellpoint Essential Gold 1500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Gold 2000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Gold 800 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Gold POS 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Wellpoint Essential Gold POS 2000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Wellpoint Essential Gold POS 700 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Wellpoint Essential Silver 1850 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Silver 3500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Silver 3500 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Silver 6000 Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
  • Wellpoint Essential Silver POS 2500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Wellpoint Essential Silver POS 4000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Jerry Mckenzie is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Jerry Mckenzie is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 345565495

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20181005002456

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $21.8 for a new patient copayment and $24.92 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 76063 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $87.2
  • Minimum New Patient Price $56.47
  • Maximum New Patient Price $171.07
  • Average New Patient Copayment $21.8
  • Minimum New Patient Copayment $14.11
  • Maximum New Patient Copayment $42.76

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $99.68
  • Minimum Established Patient Price $18.18
  • Maximum Established Patient Price $139.68
  • Average Established Patient Copayment $24.92
  • Minimum Established Patient Copayment $4.54
  • Maximum Established Patient Copayment $34.92

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1053679407, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 53. The final step is to find the difference between that total and the next multiple of ten (60 - 53 = 7).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
0
Unchanged
Pos 3
5
Doubled → 10 → 1 + 0
Pos 4
3
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
7
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
4
Unchanged
Pos 9
0
Doubled → 0
Check
7
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 5 → 10 → 1 6 → 12 → 3 9 → 18 → 9 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 0 + 1 + 0 + 3 + 1 + 2 + 7 + 1 + 8 + 4 + 0 + 24 = 53

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 53 is 60. The difference is the calculated check digit.

60 - 53 = 7
This NPI is valid
The calculated check digit is 7, which matches the last digit of 1053679407.

Other Providers at the Same Location


The following 8 providers are registered at the same or a nearby location.

Family Medicine
1720 E BROAD ST
MANSFIELD, TX 76063
Chiropractor
1720 E BROAD ST
MANSFIELD, TX 76063
Family Medicine
1720 E BROAD ST
MANSFIELD, TX 76063
Family Medicine
1720 E BROAD ST
MANSFIELD, TX 76063
Nurse Practitioner (Family)
1720 E BROAD ST
MANSFIELD, TX 76063
Clinic/Center (Primary Care)
1720 E BROAD ST
MANSFIELD, TX 76063
Nurse Practitioner (Family)
1720 E BROAD ST
MANSFIELD, TX 76063
Nurse Practitioner (Family)
1720 E BROAD ST
MANSFIELD, TX 76063

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1053679407, enumerated as an "individual" on April 23, 2012.

The provider is located at 1720 E BROAD ST MANSFIELD, TX 76063 and the phone number is (817) 453-5912.

Family Medicine with taxonomy code 207QG0300X and a focus in Geriatric Medicine.

The provider might be accepting Accepts: Ambetter from Arizona Complete Health, Ambetter. Please consult your insurance carrier or call the provider to verify.