Individual provider Active NPI

Kelsey Elizabeth Goodman Donoho, MD

  • Pediatrics Physician
  • Washington, DC
National Provider Identifier
1750745139
Registry record updated Sep 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
MD210001304 Issued in DC
Practice address
111 Michigan Ave NW
Washington, DC 20010-2916
Phone
(202) 476-3314
NPI assigned
Apr 11, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X S7202 TX
Pediatrics Physician 208000000X A141077 CA
Pediatrics Physician 208000000X MD210001304 DC Primary

Addresses

Primary practice location

111 Michigan Ave NW
Washington, DC 20010-2916

Mailing address

2429 California St NW
Washington, DC 20008-1615
Phone (949) 370-0741

Other practice location 1

4650 W Sunset Blvd
Los Angeles, CA 90027-6062
Phone (323) 361-2122

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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

Enrollment IDStateProvider typePAC IDDetails
I20211011000505 DC Practitioner - Pediatric Medicine 0446658108 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A141077CAMDPediatrics Physician
MD210001304DCMDPediatrics Physician
S7202TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital CurrentSince Sep 16, 2021 Accepting new patients
Children's Hospital Pediatrics CurrentSince Sep 16, 2021 Accepting new patients
Children's Hospital Current Accepting new patients

Locations

111 Michigan Ave NW
Washington, DC 20010
Phone (202) 476-3670

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1460332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630972800000",
    "number": "1750745139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2429 CALIFORNIA ST NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200081615",
            "telephone_number": "949-370-0741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 MICHIGAN AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200102916",
            "telephone_number": "202-476-3314"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4650 W Sunset Blvd",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900276062",
            "country_code": "US",
            "telephone_number": "323-361-2122",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DONOHO",
        "first_name": "KELSEY",
        "middle_name": "ELIZABETH GOODMAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-11",
        "last_updated": "2021-09-07",
        "certification_date": "2021-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "S7202",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CA",
            "license": "A141077",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "DC",
            "license": "MD210001304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.