Individual provider Active NPI

Douglas Kyle McDonald, MD

  • Vascular & Interventional Radiology Physician
  • Temple, TX
National Provider Identifier
1760463673
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
License
L6109 Issued in TX
Practice address
2401 S 31St St
Dept of Radiology
Temple, TX 76508-0001
Phone
(254) 724-2111
NPI assigned
Nov 8, 2005
Last updated
Jan 27, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 223375 MA
Vascular & Interventional Radiology Physician 2085R0204X L6109 TX Primary

Addresses

Primary practice location

2401 S 31St St
Dept of Radiology
Temple, TX 76508-0001

Mailing address

PO Box 844658
Dallas, TX 75284-4658

Other practice location 1

2201 S Clear Creek Rd
Killeen, TX 76549-4110
Phone (254) 526-7523

Other identifiers 3

IdentifierTypeStateIssuer
2101327MedicaidMA
462203OtherMATUFTS HEALTH PLAN
J28639OtherMABCBS MA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dmcdonald11231@direct.sw.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20040913000837 TX Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 0244207934 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
University of New Mexico School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scott and White ClinicGroup PAC ID 8123923604, 2,426 clinicians

Practice addresses (Care Compare)

1605 S 31St St
Baylor Scott and White Center for Dia
Temple, TX 76508-0001
Phone (254) 215-0100

239 W Business
190 Baylor Scott and White Clinic Coppe
Copperas Cove, TX 76522-2912
Phone (254) 542-9000

2401 S 31 St
Temple, TX 76508-0001
Phone (254) 724-2459

2401 S 31St St BLDG
35 Baylor Scott and White Roney Bone and
Temple, TX 76508-0001
Phone (254) 724-2663

425 University Blvd
Round Rock, TX 78665-1053
Phone (512) 509-0200

800 W Hwy 71
Baylor Scott and White Specialty Clinic
Marble Falls, TX 78654-8602
Phone (830) 201-7100

810 W Hwy 71
Marble Falls, TX 78654-8602
Phone (830) 201-7100

810 W U Ave
Temple, TX 76508-0001
Phone (254) 724-2585

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
223375MAMDDiagnostic Radiology Physician
L6109TXMDVascular & Interventional Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Clinic Diagnostic Radiology CurrentSince Jul 31, 2006 Accepting new patients
Btdi JV, LLP CurrentSince Oct 14, 2016 Accepting new patients
Btdi JV, LLP CurrentSince Oct 14, 2016 Accepting new patients
Btdi JV, LLP CurrentSince Oct 14, 2016 Accepting new patients
Scott & White Clinic Diagnostic Radiology CurrentSince Jul 31, 2006 Accepting new patients
Btdi JV, LLP CurrentSince Oct 14, 2016 Accepting new patients
Btdi JV, LLP CurrentSince Oct 14, 2016 Accepting new patients
Scott & White Hospital - Taylor Past Accepting new patients

Locations

101 Lafferty Ave
Cameron, TX 76520
Phone (254) 605-1100

2201 Clear Creek Rd
Killeen, TX 76549
Phone (254) 519-8185

810 W Highway 71
Marble Falls, TX 78654
Phone (830) 201-7100

1901 SW H K Dodgen Loop
Temple, TX 76502
Phone (254) 742-9256

2401 S 31st St
Temple, TX 76508
Phone (254) 724-2459

Interoperability endpoints

  • Direct secure messaging: dmcdonald11231@direct.sw.org

Organizations & group practices 8

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 6

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": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643241600000",
    "number": "1760463673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 S 31ST ST",
            "address_2": "DEPT OF RADIOLOGY",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765080001",
            "telephone_number": "254-724-2111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2201 S Clear Creek Rd",
            "address_purpose": "LOCATION",
            "city": "Killeen",
            "state": "TX",
            "postal_code": "765494110",
            "country_code": "US",
            "telephone_number": "254-526-7523",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "DOUGLAS",
        "middle_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "223375",
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "TX",
            "license": "L6109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2101327",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "462203",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "J28639",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dmcdonald11231@direct.sw.org",
            "affiliation": "N",
            "address_1": "2401 S 31st St",
            "address_2": "Dept of Radiology",
            "city": "Temple",
            "state": "TX",
            "country_code": "US",
            "postal_code": "765080001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Temple, TX

Sources for this page

Verify at the official NPI Registry.