Individual provider Active NPI

Dusten Malcolm Macdonald, M.D.

  • Radiation Oncology Physician
  • Joint Base Lewis McChord, WA
National Provider Identifier
1467550012
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
2006009929 Issued in MO
Practice address
Madigan Army Medical Ctr
9040 Fitzsimmons Drive
Joint Base Lewis McChord, WA 98431-1100
Phone
(253) 968-2133
NPI assigned
Sep 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 144677 CA
Radiation Oncology Physician 2085R0001X 60430276 WA
Radiation Oncology Physician 2085R0001X 12777 ID
Radiation Oncology Physician 2085R0001X 2006009929 MO Primary

Addresses

Primary practice location

Madigan Army Medical Ctr
9040 Fitzsimmons Drive
Joint Base Lewis McChord, WA 98431-1100

Mailing address

2700 Dolbeer St
9040 Fitzsimmons Drive
Eureka, CA 95501-4736
Phone (707) 269-4229

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dmacdonald1657996@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160920002570 CA Practitioner - Radiation Oncology 3072743764 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Medical College of Wisconsin, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Eureka Radiation Oncology ConsultantsGroup PAC ID 7719365618, 3 clinicians

Practice addresses (Care Compare)

2700 Dolbeer St
Eureka, CA 95501-4736
Phone (707) 269-4229

Hospital & facility affiliations

  • Providence St Joseph Hospital Hospital, Eureka, CA, CCN 050006
  • Mad River Community Hospital Hospital, Arcata, CA, CCN 050028
  • Sutter Coast Hospital Hospital, Crescent City, CA, CCN 050417
  • Adventist Health Ukiah Valley Hospital, Ukiah, CA, CCN 050301
  • Providence Redwood Memorial Hospital Hospital, Fortuna, CA, CCN 051318

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
144677CAMDRadiation Oncology Physician
12777IDMDRadiation Oncology Physician
2006009929MOMDRadiation Oncology Physician
60430276WAMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Medical Foundation CurrentSince Aug 28, 2017 Accepting new patients
Eureka Radiation Oncology Consultants CurrentSince Apr 7, 2022 Accepting new patients
Providence Medical Foundation Current Accepting new patients
Providence Medical Foundation CurrentSince Aug 28, 2017 Accepting new patients

Locations

2700 Dolbeer St
Eureka, CA 95501
Phone (707) 269-4229

2700 Dolbeer St
#9040
Eureka, CA 95501

500 Doyle Park Dr
Ste 100
Santa Rosa, CA 95405
Phone (714) 449-4842

1165 Montgomery Dr
Santa Rosa, CA 95405
Phone (707) 525-5300

1165 Montgomery Dr
#1112
Santa Rosa, CA 95405
Phone (707) 546-3210

Organizations & group practices 5

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 9

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": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636329600000",
    "number": "1467550012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 DOLBEER ST",
            "address_2": "9040 FITZSIMMONS DRIVE",
            "city": "EUREKA",
            "state": "CA",
            "postal_code": "955014736",
            "telephone_number": "707-269-4229",
            "fax_number": "707-269-3849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MADIGAN ARMY MEDICAL CTR",
            "address_2": "9040 FITZSIMMONS DRIVE",
            "city": "JOINT BASE LEWIS MCCHORD",
            "state": "WA",
            "postal_code": "984311100",
            "telephone_number": "253-968-2133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDONALD",
        "first_name": "DUSTEN",
        "middle_name": "MALCOLM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "CA",
            "license": "144677",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "WA",
            "license": "60430276",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "ID",
            "license": "12777",
            "primary": false
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MO",
            "license": "2006009929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dmacdonald1657996@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "2700 Dolbeer St",
            "city": "Eureka",
            "state": "CA",
            "country_code": "US",
            "postal_code": "955014736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Joint Base Lewis McChord, WA

Sources for this page

Verify at the official NPI Registry.