Individual provider Active NPI

Robert Riordan Mac Donald, M.D.

  • Otolaryngology Physician
  • Saint Peters, MO
National Provider Identifier
1861417156
Registry record updated Apr 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MO103596 Issued in MO
Practice address
4790 Executive Centre Pkwy
Saint Peters, MO 63376-1606
Phone
(636) 441-3100
Fax
(636) 441-6784
NPI assigned
Jul 13, 2006
Last updated
Apr 11, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MO103596 MO Primary

Addresses

Primary practice location

4790 Executive Centre Pkwy
Saint Peters, MO 63376-1606

Mailing address

4790 Executive Centre Pkwy
Saint Peters, MO 63376-1606
Phone (636) 441-3100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20110323000563 MO Practitioner - OtolaryngologyPractitioner - Allergy/Immunology 0941374235 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Allergy/Immunology
Education
Washington University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Midwest ENT Centre, PCGroup PAC ID 5597839878, 12 clinicians

Practice addresses (Care Compare)

4790 Executive Centre Pkwy
Saint Peters, MO 63376-1606
Phone (636) 441-3100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.44 of 100Reported as group
Quality
100
Improvement activities
40
Cost
74.79

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MO103596MOMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Analytical Pathology Services LTD Current Accepting new patients
Midwest ENT Centre, PC Otolaryngology CurrentSince Feb 25, 2002 Accepting new patients

Locations

1225 Graham Rd
Florissant, MO 63031
Phone (314) 653-5630

11133 Dunn Rd
Saint Louis, MO 63136
Phone (314) 653-5000

4790 Executive Centre Pkwy
Saint Peters, MO 63376
Phone (636) 441-3100

Interoperability endpoints

  • Direct secure messaging: robertmacdonald@mentc.allscriptsdirect.net

Organizations & group practices 2

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": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334102400000",
    "number": "1861417156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4790 EXECUTIVE CENTRE PKWY",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761606",
            "telephone_number": "636-441-3100",
            "fax_number": "636-441-6784"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4790 EXECUTIVE CENTRE PKWY",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633761606",
            "telephone_number": "636-441-3100",
            "fax_number": "636-441-6784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAC DONALD",
        "first_name": "ROBERT",
        "middle_name": "RIORDAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2012-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MO",
            "license": "MO103596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Peters, MO

Sources for this page

Verify at the official NPI Registry.