Individual provider Active NPI

Justin Donaghy, M.D.

  • Neurology Physician
  • Worcester, MA
National Provider Identifier
1558712992
Registry record updated May 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
287713 Issued in MA
Practice address
123 Summer St Ste 660
Worcester, MA 01608-1216
Phone
(508) 363-9030
Fax
(508) 363-9037
NPI assigned
Jun 27, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 267494 MA
Neurology Physician 2084N0400X 287713 MA Primary

Addresses

Primary practice location

123 Summer St Ste 660
Worcester, MA 01608-1216

Mailing address

14 Monument SQ Ste 401
Leominster, MA 01453-5766
Phone (978) 728-4455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20210610001001 MA Practitioner - Neurology 7911285127 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Community Neuroscience Services LLCGroup PAC ID 1658688031, 23 clinicians

Practice addresses (Care Compare)

123 Summer St
Worcester, MA 01608-1216

33 Lyman St
Suite 400
Westborough, MA 01581-1434
Phone (508) 898-0055

Hospital & facility affiliations

  • St Vincent Hospital Hospital, Worcester, MA, CCN 220176
  • Umass Memorial Health - Harrington Hospital Hospital, Southbridge, MA, CCN 220019

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
82.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
287713MAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Vincent Physician Services, Inc. Internal Medicine CurrentSince May 9, 2021 Accepting new patients
Community Neuroscience Services, LLC Neurology CurrentSince Jul 1, 2021 Accepting new patients
Tak Medical Group, P.C. PastSince May 9, 2021 Accepting new patients

Locations

14 Monument Sq
Ste 401
Leominster, MA 01453
Phone (978) 728-4455

33 Lyman St
Ste 400
Westborough, MA 01581
Phone (508) 898-0055

123 Summer St
Ste 660
Worcester, MA 01608
Phone (508) 363-6330

123 Summer St
Worcester, MA 01608
Phone (508) 363-6000

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IJCCDA

Organizations & group practices 3

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 2

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": "1466985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620345600000",
    "number": "1558712992",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 MONUMENT SQ STE 401",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014535766",
            "telephone_number": "978-728-4455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 SUMMER ST STE 660",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081216",
            "telephone_number": "508-363-9030",
            "fax_number": "508-363-9037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONAGHY",
        "first_name": "JUSTIN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-27",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "267494",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MA",
            "license": "287713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.