Individual provider Active NPI

Matthew Sean Donegan, CRNA

  • Certified Registered Nurse Anesthetist
  • Overland Park, KS
National Provider Identifier
1497086789
Registry record updated Mar 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
110964 Issued in KS
Practice address
5721 W 119TH St
Aakc Menorah Medical Center
Overland Park, KS 66209-3722
Phone
(913) 498-6000
NPI assigned
Jan 26, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 110964 KS Primary

Addresses

Primary practice location

5721 W 119TH St
Aakc Menorah Medical Center
Overland Park, KS 66209-3722

Mailing address

6611 W 335TH St
Louisburg, KS 66053-7156
Phone (913) 980-4468

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS, MO2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20100712000051 KS Practitioner - Certified Registered Nurse Anesthetist (Crna) 7618009655 Reassigns benefits to 5 organizations
I20160620000495 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 7618009655 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
110964KSMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Care, LLC Current Accepting new patients
Ottawa Anesthesia LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2013 Accepting new patients
Saint Luke'S Hospital of Allen County, Inc Current Accepting new patients
Saint Lukes Hospital of Garnett Inc Current Accepting new patients
Eye Care LLC CurrentSince Oct 1, 2017 Accepting new patients
Digestive Health Specialists, LLC CurrentSince Oct 17, 2016 Accepting new patients
Anesthesia Associates of Kansas City PA Past Accepting new patients
Novamed Eye Surgery Center of Overland Park, LLC Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

421 S Maple St
Garnett, KS 66032
Phone (785) 204-7105

3066 N Kentucky St
Iola, KS 66749
Phone (620) 365-1000

11500 Granada St
Leawood, KS 66211
Phone (816) 350-6902

1301 S Main St
Ottawa, KS 66067
Phone (785) 229-3367

5520 College Blvd
Ste 200
Overland Park, KS 66211
Phone (913) 491-3040

670 S Commercial St
Harrisonville, MO 64701

3800 S Whitney Ave
Ste 100
Independence, MO 64055

4741 S Cochise Dr
Independence, MO 64055
Phone (816) 542-2849

3800 S Whitney Ave
Ste 200
Independence, MO 64055

9601 NE 79th St
Kansas City, MO 64158

3310 W 10th St
Sedalia, MO 65301
Phone (660) 829-2837

Interoperability endpoints

  • Direct secure messaging: mdonegan231408@direct.saint-lukes.org

Organizations & group practices 10

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": "1264464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1269907200000",
    "number": "1497086789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6611 W 335TH ST",
            "city": "LOUISBURG",
            "state": "KS",
            "postal_code": "660537156",
            "telephone_number": "913-980-4468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5721 W 119TH ST",
            "address_2": "AAKC MENORAH MEDICAL CENTER",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662093722",
            "telephone_number": "913-498-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONEGAN",
        "first_name": "MATTHEW",
        "middle_name": "SEAN",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-26",
        "last_updated": "2010-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "KS",
            "license": "110964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.