Mark W. Donnelly, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

MD23406 Issued in OR

Practice address

525 N Santiam Hwy
Lebanon, OR 97355-4363

Phone

(541) 451-7115

Fax

(541) 451-7095

NPI assigned

Jun 16, 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

Medicare fee-for-service enrollment

Enrolled in OR

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

Oregon Health Sciences University School of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Santiam Memorial HospitalGroup PAC ID 6103729751, 128 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Santiam Hospital & Clinics Hospital, Stayton, OR, CCN 380056

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Santiam Memorial Hospital

  • General Acute Care Hospital
  • Stayton, OR
  • NPI 1154302214
  Medicare reassignment Care Compare group NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Roseburg, OR
  • NPI 1780647719
  Medicare reassignment NPD
• Good Shepherd Health Care System

  • Critical Access Hospital
  • Hermiston, OR
  • NPI 1295789667
  Medicare reassignment NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Coos Bay, OR
  • NPI 1063893402
  NPD
• Santiam Memorial Hospital

  • Medical Specialty Clinic/Center
  • Stayton, OR
  • NPI 1275049850
  NPD
• Santiam Memorial Hospital

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Stayton, OR
  • NPI 1801787171
  NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1700747946
  NPD
• Firstcare Medical Foundation

  • Family Medicine Physician
  • Albany, OR
  • NPI 1740216498

  Emergency Medicine

  NPD (past)
• Salem Emergency Physicians Service, PC

  • Emergency Medicine Physician
  • Salem, OR
  • NPI 1063454395
  NPD (past)

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

• Santiam Memorial Hospital

  • General Acute Care Hospital
  • Stayton, OR
  • NPI 1154302214
  Care Compare affiliation
• Santiam Memorial Hospital

  • Ambulance
  • Stayton, OR
  • NPI 1962566752

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323302400000",
    "number": "1700820784",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 N SANTIAM HWY",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973554363",
            "telephone_number": "541-451-7115",
            "fax_number": "541-451-7095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 N SANTIAM HWY",
            "city": "LEBANON",
            "state": "OR",
            "postal_code": "973554363",
            "telephone_number": "541-451-7115",
            "fax_number": "541-451-7095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "MARK",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2011-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OR",
            "license": "MD23406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Giulia Di Bella
• Kyle Thomas Dickens, RPH,PHARMD,MHA
• Gabriel Dobrichkov
• Docare,LLC
• Claire Donley
• Robyn Lynn Dreibelbis, DO
• Rebecca Lynn Duce
• Darlea R Duke, RN
• Saakshi Dulani
• Brooke Lauren Dunaway

• Emergency Medicine Physician in Lebanon, OR
• Providers in Lebanon, OR by specialty
• Emergency Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; 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.