Shaun P McDonald, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

42905020 Issued in WI

Practice address

515 S Washburn St
Suite 204
Oshkosh, WI 54904-7975

Phone

(920) 232-1130

NPI assigned

Jul 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WI

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

Dermatology

Education

University of Texas Medical School at San Antonio, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Fox Valley Dermatology SCGroup PAC ID 4284657461, 2 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

94.49 of 100Reported as individual

Quality

88.98

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Fox Valley Dermatology SC

  • Dermatology Physician
  • Oshkosh, WI
  • NPI 1316951213
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278633600000",
    "number": "1669486320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3420 JACKSON ST",
            "address_2": "SUITE E",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549018144",
            "telephone_number": "920-426-2211",
            "fax_number": "920-426-2231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 S WASHBURN ST",
            "address_2": "SUITE 204",
            "city": "OSHKOSH",
            "state": "WI",
            "postal_code": "549047975",
            "telephone_number": "920-232-1130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "SHAUN",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2010-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WI",
            "license": "42905020",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "34045300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caroline C McDonald, MD
• Donald J McDonald, MD
• Mary F McDonald, MD
• Patricia Blinn McDonald, REGISTERED NURSE
• Robert S McDonald, MD
• Heather McElhatton
• Christopher S. McFarlane, D.D.S.
• Michael W. McFarlane, D.D.S.
• Tess McFarlane, PT, DPT
• McKenna Riley McGill Barden, FNP

• Dermatology Physician in Oshkosh, WI
• Providers in Oshkosh, WI by specialty
• Dermatology Physician in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2010; 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.