Mark C McDonald, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

1305-023 Issued in WI

Practice address

8700 W Watertown Plank Rd
Orthopaedic Surgery
Milwaukee, WI 53226

Phone

(414) 805-8602

Fax

(414) 805-7171

NPI assigned

Dec 23, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532908800000",
    "number": "1861479479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "S68W15500 JANESVILLE RD",
            "city": "MUSKEGO",
            "state": "WI",
            "postal_code": "531502613",
            "telephone_number": "414-422-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8700 W WATERTOWN PLANK RD",
            "address_2": "ORTHOPAEDIC SURGERY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "53226",
            "telephone_number": "414-805-8602",
            "fax_number": "414-805-7171"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8700 W Watertown Plank Rd",
            "address_2": "Orthopaedic Surgery",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263595",
            "country_code": "US",
            "telephone_number": "414-805-8602",
            "fax_number": "414-805-7171",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "MARK",
        "middle_name": "C",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-23",
        "last_updated": "2018-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "1305-023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "41923400",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1861479479",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Patrick McDevitt, MD
• Michelle M McDonagh, RD
• Daniel Ryan McDonald, MD
• Lindsey Mae McDonald, SLPA
• Mariann L McDonald, R.N.
• Michelle Helene McDonald, RN
• Stephanie M McDonald, PT
• Mary A. McDonnell, OTR
• Timothy Robert McDonnell, OTR
• Benjamin Douglas McDowell, M.D.

• Physician Assistant in Milwaukee, WI
• Providers in Milwaukee, WI by specialty
• Physician Assistant in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.