Kelly McDonough, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

258025 Issued in MA

Practice address

101 Dudley St
Providence, RI 02905-2401

Phone

(401) 274-1122

Fax

(401) 453-7597

NPI assigned

Jun 24, 2011

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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

Specialty

Emergency Medicine

Education

University of New England, College of Osteo Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Coastal Medical AssociatesGroup PAC ID 7113029257, 443 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• South Shore Hospital Hospital, South Weymouth, MA, CCN 220100

Merit-based Incentive Payment System (MIPS)

Final score

92.4 of 100Reported as group

Quality

82.53

Improvement activities

40

Cost

73.37

Merit-based Incentive Payment System (MIPS)

Final score

86.65 of 100Reported as group

Quality

88.12

Promoting interoperability

71

Improvement activities

40

Cost

77.69

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Coastal Medical Associates

  • Anesthesiology Physician
  • Weymouth, MA
  • NPI 1932175684
  Medicare reassignment Care Compare group
• Steward Emergency Physicians, Inc

  • Emergency Medicine Physician
  • Ayer, MA
  • NPI 1780971275
  Medicare reassignment NPD
• Tufts Medical Center Ep LLC

  • Emergency Medicine Physician
  • Boston, MA
  • NPI 1609015262
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• South Shore Hospital Inc.

  • General Acute Care Hospital
  • South Weymouth, MA
  • NPI 1134227606
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1308873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605052800000",
    "number": "1578859872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 DUDLEY ST",
            "address_2": "PHO OFFICE",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029052401",
            "telephone_number": "401-274-1122",
            "fax_number": "401-453-7597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 DUDLEY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029052401",
            "telephone_number": "401-274-1122",
            "fax_number": "401-453-7597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONOUGH",
        "first_name": "KELLY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-24",
        "last_updated": "2020-11-11",
        "certification_date": "2020-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "258025",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "RI",
            "license": "LP02223",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leah Jean McDonald, M.D.
• Thomas Allen McDonald, PA-C
• Brandi J McDonnell
• Moira Keogh McDonnell, MS CCC-SLP
• Denise M McDonough, MSW, LICSW
• Elisa Kathleen McEachern, MD
• Morgan E. McFarland, NP
• Chris McFaun
• Courtney Ryan McGair, LICSW
• Patrick Thomas McGann, M.D. M.S.

• Emergency Medicine Physician in Providence, RI
• Providers in Providence, RI by specialty
• Emergency Medicine Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.