Matthew Sean McDonough, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

25999 Issued in NE

Practice address

559 Vincent St
Attn 21Mdos/Sgoc - Pediatrics
Peterson Afb, CO 80914-1541

Phone

(719) 556-1197

Fax

(866) 867-7926

NPI assigned

May 5, 2009

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

Medicare fee-for-service enrollment

Enrolled in GU

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1241481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540857600000",
    "number": "1891929972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "559 VINCENT ST",
            "address_2": "ATTN 21MDOS/SGOC - PEDIATRICS",
            "city": "PETERSON AFB",
            "state": "CO",
            "postal_code": "809141541",
            "telephone_number": "719-556-1197",
            "fax_number": "866-867-7926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "559 VINCENT ST",
            "address_2": "ATTN 21MDOS/SGOC - PEDIATRICS",
            "city": "PETERSON AFB",
            "state": "CO",
            "postal_code": "809141541",
            "telephone_number": "719-556-1197",
            "fax_number": "866-867-7926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONOUGH",
        "first_name": "MATTHEW",
        "middle_name": "SEAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-05",
        "last_updated": "2018-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NE",
            "license": "25999",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Misha Levit, DDS
• Shelly Lloyd, MSW, LCSW
• James Arthur Loe, DMD
• Winnie Lok, RPH
• Scott Lee Maynard, LMSW
• Mary B Medige
• Joseph Edward Meno III, USAF IDMT-PARAMEDIC
• Michelle Montgomery, WHNP
• Andrew Erle Moore, M.D.
• Janel Sharp Moreno, ARNP

• Pediatrics Physician in Peterson Afb, CO
• Providers in Peterson Afb, CO by specialty
• Pediatrics Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.