Jeremiah Paul Donovan, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

MD24904 Issued in ME

Practice address

1500 Duarte Rd
Duarte, CA 91010-3012

Phone

(626) 256-4673

NPI assigned

Nov 30, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 2

Other names 1

• Dr. Jeremiah P. Donovan Professional name

Electronic endpoints 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jdonovan2499284@direct.ccf.org

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.

• Collier Hma Physician Management LLC

  • Internal Medicine Physician
  • Naples, FL
  • NPI 1245282979
  Medicare reassignment NPD
• Key West Hma Physician Management, LLC

  • Internal Medicine Physician
  • Cudjoe Key, FL
  • NPI 1871548651
  Medicare reassignment NPD
• Lee Memorial Health System

  • Internal Medicine Physician
  • Fort Myers, FL
  • NPI 1992873319
  Medicare reassignment NPD
• Collier Hma Physician Management LLC

  • Optometrist
  • Naples, FL
  • NPI 1962713248
  NPD
• Euclid Hospital Cleveland Clinic Health System

  • General Acute Care Hospital
  • Euclid, OH
  • NPI 1457403016
  NPD
• Key West Hma Physician Management LLC

  • Orthopaedic Surgery Physician
  • Key West, FL
  • NPI 1346548229
  NPD
• Lee Memorial Health System

  • Federally Qualified Health Center (FQHC)
  • Port Charlotte, FL
  • NPI 1255171765
  NPD
• Creighton University

  • Allergy & Immunology (Internal Medicine) Physician
  • Omaha, NE
  • NPI 1295777225

  Gastroenterology

  NPD (past)
• Creighton University

  • Physical Therapist
  • Omaha, NE
  • NPI 1780172304
  NPD (past)
• Mary Immaculate Hospital LLC

  • General Acute Care Hospital
  • Newport News, VA
  • NPI 1538535463
  NPD (past)
• St Lucie Medical Specialists LLC

  • Family Medicine Physician
  • Port St Lucie, FL
  • NPI 1548447535

  Gastroenterology

  NPD (past)

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1164406500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6451 N FEDERAL HWY STE 800",
            "city": "FT LAUDERDALE",
            "state": "FL",
            "postal_code": "333081409",
            "telephone_number": "800-586-5022",
            "fax_number": "866-889-7835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 DUARTE RD",
            "city": "DUARTE",
            "state": "CA",
            "postal_code": "910103012",
            "telephone_number": "626-256-4673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "222 N 7th St",
            "address_purpose": "LOCATION",
            "city": "Bismarck",
            "state": "ND",
            "postal_code": "585014436",
            "country_code": "US",
            "telephone_number": "701-323-6000",
            "fax_number": "701-323-5709",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "840 E Hill Ave",
            "address_purpose": "LOCATION",
            "city": "Moses Lake",
            "state": "WA",
            "postal_code": "988372238",
            "country_code": "US",
            "telephone_number": "509-663-8711",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6235 Anello Dr",
            "address_purpose": "LOCATION",
            "city": "Melbourne",
            "state": "FL",
            "postal_code": "32940",
            "country_code": "US",
            "telephone_number": "772-834-9347",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONOVAN",
        "first_name": "JEREMIAH",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "WA",
            "license": "MD60692631",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CA",
            "license": "G150240",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "FL",
            "license": "ME95167",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "ND",
            "license": "13130",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "ME",
            "license": "MD24904",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "15201",
            "state": "ND"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "37233",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0764.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "840 E Hill Ave",
            "city": "Moses Lake",
            "state": "WA",
            "country_code": "US",
            "postal_code": "988372238",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JEREMIAH",
            "last_name": "DONOVAN",
            "middle_name": "P.",
            "prefix": "DR.",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jonas Preston Doanman, PA-C
• Michael Donahue, MD
• Jennifer Dong, MS, L.AC
• Jiali Dong
• Amy E S Donner, LCSW
• Tanya B Dorff, M.D.
• Ashley A. Dorn, N.P.
• Laura Analia Dorr-Uyemura, R.D.
• Simran Doshi, PHARMD
• Tiana Marie Douglas, PA-C

• Gastroenterology Physician in Duarte, CA
• Providers in Duarte, CA by specialty
• Gastroenterology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.