Heidi B Donnelly, M.D.

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

License

35073167 Issued in OH

Practice address

3025 Governors Place Blvd
Dayton, OH 45409-1330

Phone

(937) 293-5567

Fax

(937) 293-5568

NPI assigned

May 30, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Dermatology

Education

University of Illinois College of Med (CHI/Peor/Rock/CHM-Urb), 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dayton Skin Surgery Center IncGroup PAC ID 2365455276, 8 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

91.64 of 100Reported as group

Quality

100

Improvement activities

40

Cost

72.12

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: heidi.donnelly.p1@direct.daytonskin.nextgenshare.com
• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dayton Skin Surgery Center Inc

  • MOHS-Micrographic Surgery Physician
  • Dayton, OH
  • NPI 1710932454
  Medicare reassignment Care Compare group NPD Authorized official
• Governor'S Place Ambulatory Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Dayton, OH
  • NPI 1073828315
  NPD (past) Authorized official

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336435200000",
    "number": "1861449274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 OAKWOOD AVE",
            "city": "OAKWOOD",
            "state": "OH",
            "postal_code": "454192937",
            "telephone_number": "937-643-9213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3025 GOVERNORS PLACE BLVD",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454091330",
            "telephone_number": "937-293-5567",
            "fax_number": "937-293-5568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONNELLY",
        "first_name": "HEIDI",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-30",
        "last_updated": "2012-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "OH",
            "license": "35073167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laine M Donleson, CDCA
• Anne E Donlon, RN
• Dasia Annette Donlow
• Sharon Marie Donnell
• David Eugene Donnelly, DDS
• John F Donnelly, MD
• Suzanne M. Donnelly, MS, CCC-SLP
• Makaleigh Dooley
• Richard Lee Doran, LSW
• Kyra Dorney

• MOHS-Micrographic Surgery Physician in Dayton, OH
• Providers in Dayton, OH by specialty
• MOHS-Micrographic Surgery Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2012; 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.