Active NPI
Malcolm McDonald, D.O.
- Surgery Physician
- Winter Park, FL
National Provider Identifier
1750497095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- OS0002437
- Practice address
- 3009 Aloma Ave
Winter Park, FL 32792-3701 - Phone
- (407) 677-6500
- Fax
- (407) 671-9593
- NPI assigned
- Aug 21, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | OS0002437 | FL | Primary |
Addresses
Primary practice location
3009 Aloma Ave
Winter Park, FL 32792-3701
Mailing address
5415 Lake Howell Rd # 175
Winter Park, FL 32792-1033
Phone (407) 677-6500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 048079700 | Medicaid | FL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OS0002437 | FL | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1558396800000",
"number": "1750497095",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5415 LAKE HOWELL RD # 175",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327921033",
"telephone_number": "407-677-6500",
"fax_number": "407-671-9593"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3009 ALOMA AVE",
"city": "WINTER PARK",
"state": "FL",
"postal_code": "327923701",
"telephone_number": "407-677-6500",
"fax_number": "407-671-9593"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCDONALD",
"first_name": "MALCOLM",
"name_prefix": "Dr.",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-21",
"last_updated": "2019-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "FL",
"license": "OS0002437",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "048079700",
"state": "FL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Winter Park, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.