NPIMap

Individual provider Active NPI

David Lance Donaldson, M.D.

  • Diagnostic Radiology Physician
  • Lubbock, TX
National Provider Identifier
1720082274
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
K5513 Issued in TX
Practice address
4005 24TH St
Lubbock, TX 79410-1835
Phone
(806) 792-2767
Fax
(888) 861-8858
NPI assigned
Jun 10, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X K5513 TX
Diagnostic Radiology Physician 2085R0202X K5513 TX Primary

Addresses

Primary practice location

4005 24TH St
Lubbock, TX 79410-1835

Mailing address

4005 24TH St
Lubbock, TX 79410-1835
Phone (806) 792-2767

Other identifiers 6

IdentifierTypeStateIssuer
1928084OtherFIRST HEALTH
300132042OtherTXRAILROAD MEDICARE
78150060MedicaidNM
111790101OtherTXFIRSTCARE
118702307MedicaidTX
8G1351OtherTXBLUECROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050211000254 TX Practitioner - Diagnostic Radiology 9234180621 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Texas Southwestern Medical School at Dallas, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lubbock County Hospital DistrictGroup PAC ID 4385538941, 97 clinicians

Practice addresses (Care Compare)

602 Indiana Ave
Lubbock, TX 79415-3364
Phone (806) 775-8400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
K5513TXMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lubbock County Hospital District Diagnostic Radiology CurrentSince Nov 2, 2022 Accepting new patients
Radiology Associates of North Texas PA Diagnostic Radiology CurrentSince Jan 1, 2022 Accepting new patients
Lubbock County Hospital District Diagnostic Radiology CurrentSince Nov 2, 2022 Accepting new patients

Locations

17980 Dallas Pkwy
Ste 200
Dallas, TX 75287
Phone (972) 248-1303

816 W Cannon St
Ft Worth, TX 76104
Phone (817) 321-0312

815 Pennsylvania Ave
Ft Worth, TX 76104
Phone (817) 321-0300

602 Indiana Ave
Lubbock, TX 79415
Phone (806) 743-2898

11011 Slide Rd
Lubbock, TX 79424
Phone (806) 743-2584

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 9

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": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1720082274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4005 24TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101835",
            "telephone_number": "806-792-2767",
            "fax_number": "806-791-6709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4005 24TH ST",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101835",
            "telephone_number": "806-792-2767",
            "fax_number": "888-861-8858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONALDSON",
        "first_name": "DAVID",
        "middle_name": "LANCE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "TX",
            "license": "K5513",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "TX",
            "license": "K5513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "1928084",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300132042",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78150060",
            "state": "NM"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTCARE",
            "identifier": "111790101",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "118702307",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS",
            "identifier": "8G1351",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.