Mary Katherine McGonagle, D.O.

Primary specialty

Dermatopathology (Pathology) PhysicianTaxonomy code 207ZD0900X

License

OS013614 Issued in PA

Practice address

3805 W Chester Pike
BLDG D, Suite 120
Newtown Square, PA 19073-2329

Phone

(800) 257-0117

Fax

(610) 550-3079

NPI assigned

May 23, 2006

Last updated

Sep 23, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mary Katherine Gibbons Former name

Medicare fee-for-service enrollment

Enrolled in PA

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 Osteopathy

Practice roles

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.

• Baldassano Dermatopathology, PC

  • Dermatopathology Physician
  • Lower Gwynned, PA
  • NPI 1427000686
  Medicare reassignment NPD
• Advanced Dermatology of Pennsylvania, PC

  • Dermatology Physician
  • Philadelphia, PA
  • NPI 1740671767
  NPD (past)
• Allergy Asthma & Arthritis Associates P C

  • Allergy & Immunology Physician
  • Newtown, PA
  • NPI 1952364739
  NPD (past)
• Andrew K Pollack

  • Dermatology Physician
  • Fort Washington, PA
  • NPI 1760555924
  NPD (past)
• Bucks-Mont Dermatology Associates PC

  • Dermatology Physician
  • Doylestown, PA
  • NPI 1992791156
  NPD (past)
• Institute for Dermatopathology, Inc.

  • Clinical Medical Laboratory
  • Flourtown, PA
  • NPI 1093595829
  NPD (past)
• Institute for Dermatopathology, Inc.

  • Clinical Medical Laboratory
  • Newtown Square, PA
  • NPI 1538131362
  NPD (past)

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411430400000",
    "number": "1972558781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14275 MIDWAY RD",
            "address_2": "SUITE 400",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750013614",
            "telephone_number": "800-257-0117",
            "fax_number": "610-550-3079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3805 W CHESTER PIKE",
            "address_2": "BLDG D, SUITE 120",
            "city": "NEWTOWN SQUARE",
            "state": "PA",
            "postal_code": "190732329",
            "telephone_number": "800-257-0117",
            "fax_number": "610-550-3079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGONAGLE",
        "first_name": "MARY",
        "middle_name": "KATHERINE",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-23",
        "last_updated": "2014-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "PA",
            "license": "OS013614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "GIBBONS",
            "middle_name": "KATHERINE",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Maxillo Facial Surgeons LTD
• Carolyn A Maye, P.T.
• Junior Formukong Mbipeh, COTA/L
• Ashley McAllister, DPT
• Catherine Debow McGinty, FNP
• Alexis H McIntyre
• Michelle McIntyre, DPT
• Cory Elizabeth McMillen, MS,LAT,ATC
• Catherine McNally, LCSW
• Devon Blake Merkle, DO

• Dermatopathology (Pathology) Physician in Newtown Square, PA
• Providers in Newtown Square, PA by specialty
• Dermatopathology (Pathology) Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2014; 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.