Individual provider Active NPI

James S McDonough

  • Psychiatry Physician
  • Longwood, FL
National Provider Identifier
1063468700
Registry record updated Mar 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
ME91562 Issued in FL
Practice address
455 W Warren Ave
Longwood, FL 32750-4002
Phone
(407) 262-2220
Fax
(407) 834-5011
NPI assigned
May 25, 2006
Last updated
Mar 11, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X ME91562 FL Primary

Addresses

Primary practice location

455 W Warren Ave
Longwood, FL 32750-4002

Mailing address

455 W Warren Ave
Longwood, FL 32750-4002
Phone (407) 262-2220

Other identifiers 1

IdentifierTypeStateIssuer
271252100MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041229000314 FL Practitioner - Psychiatry 4082672647 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Advanced Behavioral Health Center PAGroup PAC ID 7315904000, 7 clinicians

Practice addresses (Care Compare)

1799 Salk Ave
Tavares, FL 32778-4311
Phone (352) 742-8300

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Behavioral Health Center PA Psychiatry CurrentSince Jul 1, 2016 Accepting new patients

Locations

1799 Salk Ave
Tavares, FL 32778
Phone (352) 742-0445

Networks

  • Freedom Health HMO Network

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299801600000",
    "number": "1063468700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 W WARREN AVE",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504002",
            "telephone_number": "407-262-2220",
            "fax_number": "407-834-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 W WARREN AVE",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504002",
            "telephone_number": "407-262-2220",
            "fax_number": "407-834-5011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONOUGH",
        "first_name": "JAMES",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2011-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "FL",
            "license": "ME91562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "271252100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longwood, FL

Sources for this page

Verify at the official NPI Registry.