Individual provider Active NPI

Paul Henry Macdonald, M.D.

  • Pediatrics Physician
  • Steubenville, OH
National Provider Identifier
1265416929
Registry record updated Jan 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
A064678 Issued in CA
Practice address
200 Luray Dr
Steubenville, OH 43953-3973
Phone
(740) 314-8258
Fax
(707) 462-1111
NPI assigned
Dec 5, 2005
Last updated
Jan 30, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X A064678 CA Primary

Addresses

Primary practice location

200 Luray Dr
Steubenville, OH 43953-3973

Mailing address

1502 Pershing Avenue
Steubenville, OH 43952
Phone (707) 463-8000

Other identifiers 1

IdentifierTypeStateIssuer
00A646780MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, WV2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170130002930 OH Practitioner - Pediatric Medicine 6709774516 Reassigns benefits to 1 organization
I20170228002749 WV Practitioner - Pediatric Medicine 6709774516 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64678CAMDPediatric Dentist
27409WVMDLicensed Practical Nurse
A064678CAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Change, Incorporated CurrentSince Dec 19, 2016 Accepting new patients
Change Incorporated PastSince Dec 19, 2016 Accepting new patients

Locations

200 Luray Dr
Wintersville, OH 43953
Phone (304) 748-2828

1151 Washington St
Newell, WV 26050
Phone (304) 459-4010

3136 West St
Weirton, WV 26062
Phone (304) 748-2828

3158 West St
Weirton, WV 26062
Phone (304) 797-7733

Interoperability endpoints

  • Direct secure messaging: paul.macdonald@fmcchc.eclinicaldirectplus.com

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, 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": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1485734400000",
    "number": "1265416929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 PERSHING AVENUE",
            "city": "STEUBENVILLE",
            "state": "OH",
            "postal_code": "43952",
            "telephone_number": "707-463-8000",
            "fax_number": "707-462-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 LURAY DR",
            "city": "STEUBENVILLE",
            "state": "OH",
            "postal_code": "439533973",
            "telephone_number": "740-314-8258",
            "fax_number": "707-462-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDONALD",
        "first_name": "PAUL",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2017-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A064678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A646780",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Steubenville, OH

Sources for this page

Verify at the official NPI Registry.