Individual provider Active NPI

Desmond J. Donegan, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Falmouth, ME
National Provider Identifier
1104872050
Registry record updated Apr 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
011098 Issued in ME
Practice address
21 B Northbrook Drive
Maine Vein Center Associates, LLC
Falmouth, ME 04105-1379
Phone
(207) 774-5479
Fax
(207) 781-3493
NPI assigned
May 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X 011098 ME Primary

Addresses

Primary practice location

21 B Northbrook Drive
Maine Vein Center Associates, LLC
Falmouth, ME 04105-1379

Mailing address

21 Northbrook Dr # B
Falmouth, ME 04105-1379
Phone (207) 774-5479

Other identifiers 1

IdentifierTypeStateIssuer
330670099MedicaidME

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
011098MEMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

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": "1334188800000",
    "number": "1104872050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 NORTHBROOK DR # B",
            "city": "FALMOUTH",
            "state": "ME",
            "postal_code": "041051379",
            "telephone_number": "207-774-5479",
            "fax_number": "207-781-3493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 B NORTHBROOK DRIVE",
            "address_2": "MAINE VEIN CENTER ASSOCIATES, LLC",
            "city": "FALMOUTH",
            "state": "ME",
            "postal_code": "041051379",
            "telephone_number": "207-774-5479",
            "fax_number": "207-781-3493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONEGAN",
        "first_name": "DESMOND",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2012-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "ME",
            "license": "011098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "330670099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Falmouth, ME

Sources for this page

Verify at the official NPI Registry.