Individual provider Active NPI

Dennis Joseph McDonagh, MD

  • Pulmonary Disease Physician
  • Jacksonville, FL
National Provider Identifier
1073623153
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
ME0039836 Issued in FL
Practice address
425 N Lee St
Ste 101
Jacksonville, FL 32257
Phone
(904) 549-8228
Fax
(904) 549-8230
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X ME0039836 FL Primary

Addresses

Primary practice location

425 N Lee St
Ste 101
Jacksonville, FL 32257

Mailing address

2636 Forest Circle
Jacksonville, FL 32257
Phone (904) 549-8228

Other identifiers 5

IdentifierTypeStateIssuer
08658OtherFLWELLCARE MEDICARE
15688OtherFLBLUE CROSS BLUE SHIELD
210079OtherFLAVMED
5082045OtherFLAETNA
1870729005OtherFLCIGNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040503001736 FL Practitioner - Internal MedicinePractitioner - Pulmonary Disease 6800884446 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0039836FLMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dennis J. McDonagh, M.D., P.a. Pulmonary Disease CurrentSince Mar 12, 2003 Accepting new patients
Eugene H McCoskey, D.O., P.a. Pulmonary Disease CurrentSince Feb 1, 2020 Accepting new patients

Locations

425 N Lee St
Ste 101
Jacksonville, FL 32204
Phone (904) 358-9587

1555 Kingsley Ave
Ste 404
Orange Park, FL 32073
Phone (904) 215-0700

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073623153",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2636 FOREST CIRCLE",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32257",
            "telephone_number": "904-549-8228",
            "fax_number": "904-549-8230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 N LEE ST",
            "address_2": "STE 101",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "32257",
            "telephone_number": "904-549-8228",
            "fax_number": "904-549-8230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONAGH",
        "first_name": "DENNIS",
        "middle_name": "JOSEPH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "ME0039836",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE MEDICARE",
            "identifier": "08658",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "15688",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AVMED",
            "identifier": "210079",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5082045",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1870729005",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.