Individual provider Active NPI

Martin Eugene McGonagle, M.D.

  • Otolaryngology Physician
  • Stephenville, TX
National Provider Identifier
1871698308
Registry record updated Jul 26, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
G6563 Issued in TX
Practice address
763 N Graham St
Stephenville, TX 76401-3148
Phone
(254) 965-7870
Fax
(254) 965-5373
NPI assigned
Sep 13, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2017

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 G6563 TX Primary

Addresses

Primary practice location

763 N Graham St
Stephenville, TX 76401-3148

Mailing address

PO Box 33648
Fort Worth, TX 76162
Phone (817) 579-2660

Other identifiers 1

IdentifierTypeStateIssuer
126628001MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Martin E McGonagle MD PA PastSince Jan 1, 1990 Accepting new patients
Martin E McGonagle MD PA PastSince Jan 1, 1990 Accepting new patients
Martin E McGonagle MD PA PastSince Jan 1, 1990 Accepting new patients
Texas Non-Surgical Orthopedic & Pain Management Clinic PastSince Oct 7, 2011 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: martine.mcgonagle@memmp-tx.direct.office.nextgen.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1501027200000",
    "number": "1871698308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33648",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "76162",
            "telephone_number": "817-579-2660",
            "fax_number": "817-579-2663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "763 N GRAHAM ST",
            "city": "STEPHENVILLE",
            "state": "TX",
            "postal_code": "764013148",
            "telephone_number": "254-965-7870",
            "fax_number": "254-965-5373"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGONAGLE",
        "first_name": "MARTIN",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2017-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "G6563",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "126628001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stephenville, TX

Sources for this page

Verify at the official NPI Registry.