Individual provider Active NPI

Cheryl McDonald, PA

  • Physician Assistant
  • Middletown, CT
National Provider Identifier
1902816812
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
000864 Issued in CT
Practice address
400 Saybrook Rd
Suite 205
Middletown, CT 06457-4773
Phone
(860) 346-7738
Fax
(860) 347-2097
NPI assigned
Aug 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 000864 CT Primary

Addresses

Primary practice location

400 Saybrook Rd
Suite 205
Middletown, CT 06457-4773

Mailing address

4 Farm Springs Rd
Prohealth Physicians
Farmington, CT 06032-2573
Phone (860) 284-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091216000399 CT Practitioner - Physician Assistant 7911047352 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Medical Group IncGroup PAC ID 1254233836, 1,357 clinicians

Practice addresses (Care Compare)

385 Church St
Guilford, CT 06437-6003
Phone (203) 453-0361

95 Armory Rd
Stratford, CT 06614-1702
Phone (203) 384-3388

Hospital & facility affiliations

  • Yale New Haven Health - Health at Home Home health agency, Milford, CT, CCN 077143
  • Yale-New Haven Hospital Hospital, New Haven, CT, CCN 070022
  • Middlesex Hospital Hospital, Middletown, CT, CCN 070020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
864CTMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Medical Group, Inc CurrentSince May 6, 2024 Accepting new patients
Northeast Medical Group, Inc. CurrentSince May 6, 2024 Accepting new patients
Prohealth Physicians, Inc. Physician Assistant Past Accepting new patients
Guilford Internal Medicine Group P.C. PastSince Oct 1, 2002 Accepting new patients

Locations

385 Church St
Ste 101
Guilford, CT 06437
Phone (203) 453-0361

95 Armory Rd
Stratford, CT 06614
Phone (203) 384-3388

Interoperability endpoints

  • Direct secure messaging: cheryl.mcdonald.npi1902816812.phpct@direct.optumcare.masshiway.net
  • Direct secure messaging: cmcdonald612838@direct.ynhh.org

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902816812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 FARM SPRINGS RD",
            "address_2": "PROHEALTH PHYSICIANS",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060322573",
            "telephone_number": "860-284-5200",
            "fax_number": "860-284-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SAYBROOK RD",
            "address_2": "SUITE 205",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574773",
            "telephone_number": "860-346-7738",
            "fax_number": "860-347-2097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "CHERYL",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CT",
            "license": "000864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, CT

Sources for this page

Verify at the official NPI Registry.