Dino Madonna, M.D

Primary specialty

Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X

License

ME78248 Issued in FL

Practice address

601 E Dixie Ave
Medical Plaza 901
Leesburg, FL 34748-5953

Phone

(352) 728-2404

Fax

(352) 787-7401

NPI assigned

Jul 26, 2005

Last updated

Jul 16, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

OtolaryngologyAlso: Plastic and Reconstructive Surgery

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lake ENT and FPS, PAGroup PAC ID 1759380447, 9 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• Direct secure messaging: dmadonna562650@direct.shands.ufl.edu

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.

• Lake ENT & FPS, PA

  dba Lake Ear, Nose Throat and Facial Plastic Surgery Associates

  • Specialist
  • Leesburg, FL
  • NPI 1629091996
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1122336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1780684399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 E DIXIE AVE",
            "address_2": "MEDICAL PLAZA 901",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485953",
            "telephone_number": "352-728-2404",
            "fax_number": "352-787-7401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E DIXIE AVE",
            "address_2": "MEDICAL PLAZA 901",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485953",
            "telephone_number": "352-728-2404",
            "fax_number": "352-787-7401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADONNA",
        "first_name": "DINO",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-26",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "FL",
            "license": "ME78248",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "FL",
            "license": "ME78248",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "256975200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Mack, APRN
• Patricia Mack, BA
• Bonni Lynn Macqueen, APN
• Macrodont Solutions Inc (Sunrise Dental)
• Hope E Maddix, APRN
• Anthony Kenrick Maharaj, PA-C
• Robert L. Maiello, M.D.
• Annamaria Maldonado, ARNP
• Diane Malecki, PTA
• Rolando M Malibiran, MD

• Facial Plastic Surgery Physician in Leesburg, FL
• Providers in Leesburg, FL by specialty
• Facial Plastic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.

Verify at the official NPI Registry.