Individual provider Active NPI

Matthew Basil McDonald III, M.D.

  • Pediatrics Physician
  • Hamilton, NJ
National Provider Identifier
1306004544
Registry record updated Feb 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
25MA09461100 Issued in NJ
Practice address
3575 Quakerbridge Rd
Hamilton, NJ 08619-1271
Phone
(609) 631-2800
Fax
(609) 631-2896
NPI assigned
May 23, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Children's Hospital 282NC2000X MT188382 PA
Pediatrics Physician 208000000X 25MA09461100 NJ Primary

Addresses

Primary practice location

3575 Quakerbridge Rd
Hamilton, NJ 08619-1271

Mailing address

379 Campus Dr FL 4
Somerset, NJ 08873-1161
Phone (732) 507-6545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20170214000610 NJ Practitioner - Pediatric Medicine 2769676808 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT188382PAMDChildren's Hospital

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Specialized Hospital Pediatrics CurrentSince Dec 21, 2016 Accepting new patients
Children' Specialized Hospital CurrentSince Dec 21, 2016 Accepting new patients
SCHC Pediatric Associates, LLC Pediatrics Past Accepting new patients

Locations

150 New Providence Rd
Mountainside, NJ 07092

200 Somerset St
New Brunswick, NJ 08901
Phone (732) 258-7000

379 Campus Dr
Fl 4
Somerset, NJ 08873
Phone (732) 507-6545

3575 Quakerbridge Rd
Trenton, NJ 08619
Phone (609) 631-2800

Organizations & group practices 3

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": "1211500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582243200000",
    "number": "1306004544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "379 CAMPUS DR FL 4",
            "city": "SOMERSET",
            "state": "NJ",
            "postal_code": "088731161",
            "telephone_number": "732-507-6545",
            "fax_number": "908-389-5675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3575 QUAKERBRIDGE RD",
            "city": "HAMILTON",
            "state": "NJ",
            "postal_code": "086191271",
            "telephone_number": "609-631-2800",
            "fax_number": "609-631-2896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "MATTHEW",
        "middle_name": "BASIL",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-23",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "282NC2000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Children",
            "state": "PA",
            "license": "MT188382",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA09461100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton, NJ

Sources for this page

Verify at the official NPI Registry.