Individual provider Active NPI

Matthew R. Donaldson, M.D.

  • Dermatology Physician
  • Grand Junction, CO
National Provider Identifier
1265624860
Registry record updated Feb 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
49785 Issued in CO
Practice address
2655 Little Bookcliff Dr
Grand Junction, CO 81501-8801
Phone
(970) 242-7273
Fax
(970) 241-2878
NPI assigned
Aug 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 49785 CO Primary

Addresses

Primary practice location

2655 Little Bookcliff Dr
Grand Junction, CO 81501-8801

Mailing address

2655 Little Bookcliff Dr
Grand Junction, CO 81501-8801
Phone (970) 242-7273

Other identifiers 1

IdentifierTypeStateIssuer
80803245MedicaidCO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110928000617 CO Practitioner - Micrographic Dermatologic Surgery (MDS)Practitioner - DermatologyPractitioner - Neurology 9739211673 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Micrographic Dermatologic Surgery (MDS)
Education
University of Utah School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain West Dermatology PCGroup PAC ID 5496647828, 9 clinicians

Practice addresses (Care Compare)

2655 Little Bookcliff Dr
Grand Junction, CO 81501-8801
Phone (970) 242-7273

Hospital & facility affiliations

  • Community Hospital Hospital, Grand Junction, CO, CCN 060054

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision107
Removal of skin lesions84
Removal of skin cancer576
Skin biopsy63

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
49785COMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain West Dermatology, PC Dermatology CurrentSince Sep 1, 2011 Accepting new patients
Skin Cancer Center Inc Past Accepting new patients

Locations

790 Wellington Ave
Ste 104
Grand Junction, CO 81501
Phone (970) 242-7273

2655 Little Bookcliff Dr
Grand Junction, CO 81501
Phone (970) 242-7273

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454284800000",
    "number": "1265624860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2655 LITTLE BOOKCLIFF DR",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018801",
            "telephone_number": "970-242-7273",
            "fax_number": "970-241-2878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2655 LITTLE BOOKCLIFF DR",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815018801",
            "telephone_number": "970-242-7273",
            "fax_number": "970-241-2878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONALDSON",
        "first_name": "MATTHEW",
        "middle_name": "R.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-16",
        "last_updated": "2016-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CO",
            "license": "49785",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "80803245",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Junction, CO

Sources for this page

Verify at the official NPI Registry.