Individual provider Active NPI

Mark J McDonald, MD

  • Pediatric Critical Care Medicine Physician
  • Louisville, KY
National Provider Identifier
1902876584
Registry record updated Mar 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
32116 Issued in KY
Practice address
200 E Chestnut St
Louisville, KY 40202-1831
Phone
(502) 629-6000
NPI assigned
Jan 25, 2006
Last updated
Mar 26, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 32116 KY
Pediatric Critical Care Medicine Physician 2080P0203X 32116 KY Primary
Pediatric Anesthesiology Physician 207LP3000X 32116 KY

Addresses

Primary practice location

200 E Chestnut St
Louisville, KY 40202-1831

Mailing address

PO Box 776879
Chicago, IL 60677-6879
Phone (502) 588-9490

Other identifiers 3

IdentifierTypeStateIssuer
200188960MedicaidIN
T66265MedicaidSC
64321169MedicaidKY

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address mmcdonald40532@direct.nortonhealthcare.org
FHIR URL https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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

Enrollment IDStateProvider typePAC IDDetails
I20100810000768 KY Practitioner - Critical Care (Intensivists)Practitioner - Pediatric Medicine 0244383792 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Pediatric Medicine
Education
Saint Louis University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

200 E Chestnut St
Louisville, KY 40202-1800
Phone (502) 588-0390

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
97.07
Promoting interoperability
100
Improvement activities
40
Cost
76.49

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
32116KYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Louisville Physicians, Inc. CurrentSince Sep 1, 2012 Accepting new patients
University of Louisville Physicians, Inc. CurrentSince Sep 1, 2012 Accepting new patients
University of Louisville Physicians, Inc. Pediatrics Current Accepting new patients
Norton Children's Medical Group, LLC Pediatric Anesthesiology CurrentSince Mar 1, 2020 Accepting new patients
Norton Children's Medical Group, LLC Current Accepting new patients
Norton Children's Medical Group, LLC CurrentSince Mar 1, 2020 Accepting new patients
University Children's Conscious Sedation Specialists, LLC Pediatric Anesthesiology Past Accepting new patients

Locations

7752 Solution Ctr
Chicago, IL 60677

200 E Chestnut St
Louisville, KY 40202
Phone (502) 446-8000

231 E Chestnut St
Louisville, KY 40202
Phone (502) 852-8500

571 S Floyd St
Louisville, KY 40202
Phone (502) 561-2700

601 S Floyd St
Ste 604
Louisville, KY 40202
Phone (502) 559-1670

Interoperability endpoints

  • Direct secure messaging: mmcdonald40532@direct.nortonhealthcare.org

Organizations & group practices 7

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

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711411200000",
    "number": "1902876584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 776879",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606776879",
            "telephone_number": "502-588-9490",
            "fax_number": "502-272-5116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 E CHESTNUT ST",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402021831",
            "telephone_number": "502-629-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "MARK",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2024-03-26",
        "certification_date": "2024-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "32116",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "KY",
            "license": "32116",
            "primary": true
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "KY",
            "license": "32116",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200188960",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "T66265",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64321169",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mmcdonald40532@direct.nortonhealthcare.org",
            "affiliation": "N",
            "address_1": "231 E Chestnut St",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402021821",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "200 E Chestnut St",
            "city": "Louisville",
            "state": "KY",
            "country_code": "US",
            "postal_code": "402021831",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.