Individual provider Active NPI

Vincent James McDonough, M.D.

  • Emergency Medicine Physician
  • Philadelphia, PA
National Provider Identifier
1447579586
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MT196615 Issued in PA
Practice address
230 N Broad St
Department of Emergency Medicine
Philadelphia, PA 19102-1121
Phone
(215) 762-7000
NPI assigned
May 28, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 49548 AZ
Emergency Medicine Physician 207P00000X MT196615 PA Primary

Addresses

Primary practice location

230 N Broad St
Department of Emergency Medicine
Philadelphia, PA 19102-1121

Mailing address

109 Lionheart LN
West Deptford, NJ 08086-2253
Phone (267) 496-8629

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20141107000805 AZ Practitioner - Emergency Medicine 7911149018 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emergency Group of Arizona Professional CorporationGroup PAC ID 1355596644, 102 clinicians

Practice addresses (Care Compare)

13677 W McDowell Rd
Goodyear, AZ 85395-2635
Phone (623) 882-1500

1930 E Thomas Rd
Phoenix, AZ 85016-7711
Phone (602) 532-1000

Hospital & facility affiliations

  • Abrazo West Campus Hospital, Goodyear, AZ, CCN 030110

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MT196615PAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Group of Arizona Professional Corporation Emergency Medicine CurrentSince Sep 1, 2014 Accepting new patients
Tec Emergency Physicians of Arizona, LLC CurrentSince Jun 1, 2022 Accepting new patients

Locations

13677 W McDowell Rd
Goodyear, AZ 85395
Phone (623) 536-4200

1930 E Thomas Rd
Phoenix, AZ 85016
Phone (602) 532-1000

1419 W Hunt Hwy
San Tan Vly, AZ 85143
Phone (480) 245-4300

5125 S Rural Rd
Tempe, AZ 85282
Phone (480) 306-8780

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": "1275004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1447579586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 LIONHEART LN",
            "city": "WEST DEPTFORD",
            "state": "NJ",
            "postal_code": "080862253",
            "telephone_number": "267-496-8629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 N BROAD ST",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191021121",
            "telephone_number": "215-762-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONOUGH",
        "first_name": "VINCENT",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-28",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "AZ",
            "license": "49548",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MT196615",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.