Organization Active NPI

Richard Macdonell MD PC

  • Internal Medicine Physician
  • Bend, OR
National Provider Identifier
1649334285
Registry record updated Feb 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD22659 Issued in OR
Legal business name
RICHARD MACDONELL MD PC
Practice address
2190 NE Professional CT
#200
Bend, OR 97701-6065
Phone
(541) 322-6869
Fax
(541) 639-3655
NPI assigned
Dec 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2013

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

Authorized official

Name
Dr. Richard Alan Mac Donell, M.D.NPI 1992745160
Title
Physician
Phone
(541) 322-6869

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X MD22659 OR Primary

Addresses

Primary practice location

2190 NE Professional CT
#200
Bend, OR 97701-6065

Mailing address

2190 NE Professional CT
#200
Bend, OR 97701-6065
Phone (541) 322-6869

Other names 1

  • MyMD Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OR

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070222000152 OR Part B Supplier - Clinic/Group Practice 6709988710 Receives reassigned benefits from 2 practitioners
Practice locations: Bend, OR

National Provider Directory

National Provider Directory

Locations

695 NW York Dr
Ste 100
Bend, OR 97703
Phone (541) 322-6869

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1361923200000",
    "number": "1649334285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2190 NE PROFESSIONAL CT",
            "address_2": "#200",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016065",
            "telephone_number": "541-322-6869",
            "fax_number": "541-639-3655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2190 NE PROFESSIONAL CT",
            "address_2": "#200",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977016065",
            "telephone_number": "541-322-6869",
            "fax_number": "541-639-3655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD MACDONELL MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-20",
        "last_updated": "2013-02-27",
        "status": "A",
        "authorized_official_last_name": "MAC DONELL",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "541-322-6869",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD22659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MyMD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bend, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2013; 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.