Individual provider Active NPI

Douglas L. McDonald, CRNA

  • Certified Registered Nurse Anesthetist
  • Indianapolis, IN
National Provider Identifier
1467462671
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
28188056A Issued in IN
Practice address
1500 N Ritter Ave
Indianapolis, IN 46219-3027
Phone
(317) 355-5539
Fax
(317) 621-7884
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 2013023216 MO
Certified Registered Nurse Anesthetist 367500000X 209-006091 IL
Certified Registered Nurse Anesthetist 367500000X 28188056A IN Primary

Addresses

Primary practice location

1500 N Ritter Ave
Indianapolis, IN 46219-3027

Mailing address

6626 E 75TH St
Suite 500
Indianapolis, IN 46250-2805

Other practice location 1

904 W Temple Ave
Effingham, IL 62401-2178
Phone (217) 342-1234

Other practice location 2

3015 N Ballas Rd
Saint Louis, MO 63131-2329
Phone (314) 996-5000

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address dmcdonald216425@eCommunityDirect.com Community Physicians of Indiana Inc
FHIR URL https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Health Information Exchange (HIE) MISSOURI BAPTIST MEDICAL CENTER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, OH, IN, MO4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20061103000212 IL Practitioner - Certified Registered Nurse Anesthetist (Crna) 7911904933 Reassigns benefits to 11 organizations
I20120213000571 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 7911904933 Reassigns benefits to 1 organization
I20140408000370 IN Practitioner - Certified Registered Nurse Anesthetist (Crna) 7911904933 Reassigns benefits to 1 organization
I20211025001546 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 7911904933 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northstar Anesthesia of Illinois, LLCGroup PAC ID 4688893878, 404 clinicians
North American Partners in Anesthesia Illinois LLCGroup PAC ID 1052576519, 431 clinicians
G and G Anesthesia LLCGroup PAC ID 4981912607, 92 clinicians

Practice addresses (Care Compare)

117 E Clark St
Harrisburg, IL 62946-2702
Phone (618) 252-0411

12866 Troxler Ave
Highland, IL 62249-2806
Phone (618) 651-2600

1423 Chicago Rd
Chicago Heights, IL 60411-3400
Phone (708) 756-1000

201 S 14TH St
Herrin, IL 62948-3631
Phone (618) 942-2171

3249 Oak Park Ave
Berwyn, IL 60402-3429
Phone (708) 783-9100

3333 W Deyoung St
Suite 62959
Marion, IL 62959-5884
Phone (618) 998-7000

503 N Maple St
Effingham, IL 62401-2006
Phone (217) 342-2121

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
209-006091ILMDCertified Registered Nurse Anesthetist
28188056AINMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
McDonough County Hospital District CurrentSince Feb 7, 2011 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Jan 31, 2017 Accepting new patients
McDonough County Hospital District Nurse Anesthetist, Certified Registered CurrentSince Feb 7, 2011 Accepting new patients
Marshall Browning Hospital Association CurrentSince Feb 24, 2024 Accepting new patients
Carle Health Care Incorporated CurrentSince Jul 22, 2019 Accepting new patients
St Anthonys Memorial Hospital of the Hospital Sisters of the Third CurrentSince Jul 13, 2022 Accepting new patients
Hoopeston Community Memorial Hospital CurrentSince Jul 22, 2019 Accepting new patients
McDonough County Hospital District Current Accepting new patients
McDonough County Hospital District Current Accepting new patients
Missouri Baptist Medical Center Nurse Anesthetist, Certified Registered CurrentSince Aug 2, 2024 Accepting new patients
McDonough County Hospital District Current Accepting new patients
North American Partners in Anesthesia (Illinois), LLC CurrentSince Aug 1, 2022 Accepting new patients
Promedica Central Physicians CurrentSince Aug 1, 2021 Accepting new patients
McDonough County Hospital District Current Accepting new patients
Marion Eye Center Anesthesia Group Inc CurrentSince Oct 1, 2016 Accepting new patients
St Anthonys Memorial Hospital of the Hospital Sisters of the Third CurrentSince Jul 13, 2022 Accepting new patients
Marshall Browning Hospital Association CurrentSince Feb 24, 2024 Accepting new patients
Apollo Medical Group LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 11, 2014 Accepting new patients
Northstar Anesthesia of Illinois, LLC Nurse Anesthetist, Certified Registered CurrentSince Feb 20, 2025 Accepting new patients
McDonough County Hospital District Current Accepting new patients
Promedica Central Physicians CurrentSince Aug 1, 2021 Accepting new patients
Sarah Bush Lincoln Health Center Current Accepting new patients
Community Physicians of Indiana Inc CurrentSince Jan 31, 2017 Accepting new patients
U S Anesthesia Partners of Kentucky PSC Nurse Anesthetist, Certified Registered CurrentSince Sep 1, 2023 Accepting new patients
Specialists in Anesthesia PC Nurse Anesthetist, Certified Registered CurrentSince Jul 18, 2017 Accepting new patients
Sarah Bush Lincoln Health Center CurrentSince May 13, 2014 Accepting new patients
Hoopeston Community Memorial Hospital CurrentSince Jul 22, 2019 Accepting new patients
Ozarks Medical Center Past Accepting new patients
Premier Anesthesia of Danville Past Accepting new patients
Eye Surgery Center of Maryville LLC Past Accepting new patients
Amsol Anesthetists of Illinois, PC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations (25 of 33)

3249 Oak Park Ave
Berwyn, IL 60402
Phone (708) 783-2696

2601 W Main St
Carbondale, IL 62901
Phone (618) 351-7300

1045 Martin Luther King Dr
Centralia, IL 62801
Phone (618) 242-3979

5819 Reliable Pkwy
Chicago, IL 60686

812 N Logan Ave
Danville, IL 61832
Phone (217) 443-5000

2300 N Edward St
Decatur, IL 62526
Phone (217) 876-3000

1800 E Lake Shore Dr
Decatur, IL 62521
Phone (217) 464-2729

900 N Washington St
Du Quoin, IL 62832
Phone (618) 542-1050

5900 Bond Ave
East Saint Louis, IL 62207
Phone (618) 332-3060

904 W Temple Ave
Effingham, IL 62401
Phone (217) 342-1234

503 N Maple St
Effingham, IL 62401
Phone (217) 342-2121

1120 N Melvin St
Gibson City, IL 60936
Phone (217) 355-1684

200 Health Care Dr
Greenville, IL 62246
Phone (618) 664-0808

701 E Orange St
Hoopeston, IL 60942
Phone (217) 283-5531

525 E Grant St
Macomb, IL 61455
Phone (309) 836-1611

1000 Health Center Dr
Mattoon, IL 61938
Phone (217) 258-2389

101 Professional Plz
Mattoon, IL 61938
Phone (217) 238-3730

8 Doctors Park Rd
Mount Vernon, IL 62864
Phone (618) 244-5500

2900 Broadway St
#B
Mount Vernon, IL 62864
Phone (618) 969-8700

1423 Chicago Rd
Sauk Village, IL 60411
Phone (708) 679-2160

1400 W Park St
Urbana, IL 61801
Phone (217) 337-2000

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

10315 Dawsons Creek Blvd
Ste Ab
Fort Wayne, IN 46825
Phone (219) 436-7875

1500 N Ritter Ave
Indianapolis, IN 46219
Phone (317) 355-5041

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/9c9d3cdf-0f7f-4b63-979a-f711747b3e95/
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: dmcdonald216425@ecommunitydirect.com

Organizations & group practices 33

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.

View all 33

Hospital & facility affiliations 6

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734912000000",
    "number": "1467462671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST",
            "address_2": "SUITE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 N RITTER AVE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462193027",
            "telephone_number": "317-355-5539",
            "fax_number": "317-621-7884"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "904 W Temple Ave",
            "address_purpose": "LOCATION",
            "city": "Effingham",
            "state": "IL",
            "postal_code": "624012178",
            "country_code": "US",
            "telephone_number": "217-342-1234",
            "fax_number": "217-342-1230",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3015 N Ballas Rd",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631312329",
            "country_code": "US",
            "telephone_number": "314-996-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "DOUGLAS",
        "middle_name": "L.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2013023216",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IL",
            "license": "209-006091",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "IN",
            "license": "28188056A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dmcdonald216425@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "1500 N Ritter Ave",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462193027",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0965.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "Y",
            "endpointDescription": "BJC",
            "affiliationName": "MISSOURI BAPTIST MEDICAL CENTER",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3015 N Ballas Rd",
            "city": "Saint Louis",
            "state": "MO",
            "country_code": "US",
            "postal_code": "631312329",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.