Individual provider Active NPI

Thomas J. McDonagh Jr., MD

  • Pediatrics Physician
  • Huntington Station, NY
National Provider Identifier
1457359077
Registry record updated Feb 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
185483-1 Issued in NY
Practice address
180 E Pulaski Rd
Huntington Station, NY 11746-1915
Phone
(631) 425-2121
Fax
(631) 425-2193
NPI assigned
Jul 8, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2008

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 185483-1 NY Primary

Addresses

Primary practice location

180 E Pulaski Rd
Huntington Station, NY 11746-1915

Mailing address

180 E Pulaski Rd
Huntington Station, NY 11746-1915
Phone (631) 425-2121

Other identifiers 1

IdentifierTypeStateIssuer
01245490MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20101215000028 NY Practitioner - Pediatric Medicine 5991871048 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Columbia University College of Physicians and Surgeons, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Shore-Lij Medical PCGroup PAC ID 3375701568, 6,374 clinicians

Practice addresses (Care Compare)

300 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3058

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
185483-1NYMDSchool Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
New York University CurrentSince Jun 15, 2015 Accepting new patients
Northwell Health Current Accepting new patients
New York University Pediatrics CurrentSince Jun 15, 2015 Accepting new patients
North Shore-Lij Medical PC CurrentSince Jun 1, 2015 Accepting new patients

Locations

241 E Main St
Fl 2
Huntington, NY 11743

180 Pulaski Rd
Huntington Station, NY 11746
Phone (631) 425-2121

300 Community Dr
Plandome, NY 11030

972 Brush Hollow Rd
Westbury, NY 11590

Networks

  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H9678

Interoperability endpoints

  • Direct secure messaging: thomasmcdonagh@northwell.allscriptsdirect.net
  • Direct secure messaging: thomasmcdonagh@nslijmedgr.allscriptsdirect.net

Organizations & group practices 4

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": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203897600000",
    "number": "1457359077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 E PULASKI RD",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117461915",
            "telephone_number": "631-425-2121",
            "fax_number": "631-425-2193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 E PULASKI RD",
            "city": "HUNTINGTON STATION",
            "state": "NY",
            "postal_code": "117461915",
            "telephone_number": "631-425-2121",
            "fax_number": "631-425-2193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONAGH",
        "first_name": "THOMAS",
        "middle_name": "J.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2008-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "185483-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01245490",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Huntington Station, NY

Sources for this page

Verify at the official NPI Registry.