Active NPI
Matthew Donnelly, CRNA
- Certified Registered Nurse Anesthetist
- Newark, DE
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- R164824
- Practice address
- 4755 Ogletown-Stanton Rd
Newark, DE 19718-0001 - Phone
- (302) 733-1000
- NPI assigned
- Jul 6, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | R164824 | MD | Primary |
Addresses
Primary practice location
4755 Ogletown-Stanton Rd
Newark, DE 19718-0001
Mailing address
255 W Michigan Ave
PO Box1123
Jackson, MI 49201-2218
Phone (517) 787-6440
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DE, MD
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
12500 Willowbrook Rd
Western Maryland Health System
Cumberland, MD 21502-6393
Phone (240) 964-7000
5401 Old Court Rd
Randallstown, MD 21133-5103
Phone (410) 521-2200
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R164824 | MD | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| North American Partners in Anesthesia Maryland LLC | Current | Accepting new patients | |
| Union Hospital of Cecil County | Current | Accepting new patients | |
| Union Hospital of Cecil County | Current | Accepting new patients |
Locations
12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255
106 Bow St
Elkton, MD 21921
Phone (410) 298-2000
5401 Old Court Rd
Randallstown, MD 21133
Phone (301) 337-2727
68 S Service Rd
Ste 350
Melville, NY 11747
Phone (516) 945-3107
Organizations & group practices 4
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.
-
- Anesthesiology Physician
- Prince Frederick, MD
- NPI 1093707879
-
- Internal Medicine Physician
- Elkton, MD
- NPI 1124067848
-
- Anesthesiology Physician
- New Castle, DE
- NPI 1053366377
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Elkton, MD
- NPI 1376523357
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183680000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1720286099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "255 W MICHIGAN AVE",
"address_2": "PO BOX1123",
"city": "JACKSON",
"state": "MI",
"postal_code": "492012218",
"telephone_number": "517-787-6440"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4755 OGLETOWN-STANTON RD",
"city": "NEWARK",
"state": "DE",
"postal_code": "197180001",
"telephone_number": "302-733-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DONNELLY",
"first_name": "MATTHEW",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "MD",
"license": "R164824",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Newark, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.