Active NPI
Robert J McDonald Jr., MD
- Otolaryngology Physician
- Jefferson City, MO
National Provider Identifier
1033184007
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- MDR1K87
- Practice address
- 3527 W Truman Blvd
Ste 200
Jefferson City, MO 65109-5715 - Phone
- (573) 659-5570
- Fax
- (573) 659-5577
- NPI assigned
- Feb 22, 2006
- Last updated
- Aug 17, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | MDR1K87 | MO | Primary |
Addresses
Primary practice location
3527 W Truman Blvd
Ste 200
Jefferson City, MO 65109-5715
Mailing address
3527 W Truman Blvd
Ste 200
Jefferson City, MO 65109-5715
Phone (573) 659-5570
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00061459 | Other | MO | RAILROAD MEDICARE |
| 206789521 | Medicaid | MO | |
| 24321 | Other | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Otolaryngology
- Education
- University of Missouri, Columbia School of Medicine, 1988
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
3527 W Truman Blvd
Suite 200
Jefferson City, MO 65109-5715
3527 W Truman Blvd
Suite 200
Jefferson City, MO 65109-5902
Phone (573) 659-5570
Hospital & facility affiliations
- University of Missouri Health Care
- SSM Health St. Mary's Hospital - Jefferson City
- Lake Regional Health System
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MDR1K87 | MO | MD | Otolaryngology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Central Mo Ear, Nose, Throat, & Sinus, P.C. | Current | Accepting new patients |
Locations
1705 Christy Dr
Ste 214
Jefferson Cty, MO 65101
Phone (573) 659-5570
3527 W Truman Blvd
Ste 200
Jefferson Cty, MO 65109
Phone (573) 635-7901
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Specialist
- Jefferson City, MO
- NPI 1013050970
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Capital Region Medical Center
- General Acute Care Hospital
- Jefferson City, MO
- NPI 1174597892
-
dba University of Missouri Health Care
- General Acute Care Hospital
- Columbia, MO
- NPI 1699769901
-
- Rural Acute Care Hospital
- Osage Beach, MO
- NPI 1386619450
-
dba SSM Health St. Mary's Hospital Jefferson City
- General Acute Care Hospital
- Jefferson City, MO
- NPI 1518065523
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1660694400000",
"number": "1033184007",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3527 W TRUMAN BLVD",
"address_2": "STE 200",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "651095715",
"telephone_number": "573-659-5570",
"fax_number": "573-659-5577"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3527 W TRUMAN BLVD",
"address_2": "STE 200",
"city": "JEFFERSON CITY",
"state": "MO",
"postal_code": "651095715",
"telephone_number": "573-659-5570",
"fax_number": "573-659-5577"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONALD",
"first_name": "ROBERT",
"middle_name": "J",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-22",
"last_updated": "2022-08-17",
"certification_date": "2022-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "MO",
"license": "MDR1K87",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00061459",
"state": "MO"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "206789521",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "24321",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Jefferson City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.