NPIMap

Individual provider Active NPI

Jonathan Richard McDonagh, MD

  • Vascular Surgery Physician
  • Anchorage, AK
National Provider Identifier
1972609949
Registry record updated May 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
5821 Issued in AK
Practice address
3841 Piper St
Suite T-100
Anchorage, AK 99508-4624
Phone
(907) 561-3211
Fax
(907) 771-6870
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 4301097900 MI
Cardiovascular Disease Physician 207RC0000X 5821 AK
Interventional Cardiology Physician 207RI0011X 5821 AK
Vascular Surgery Physician 2086S0129X 5821 AK Primary

Addresses

Primary practice location

3841 Piper St
Suite T-100
Anchorage, AK 99508-4624

Mailing address

PO Box 200149
Anchorage, AK 99520-0149
Phone (907) 561-3211

Other identifiers 2

IdentifierTypeStateIssuer
8424384MedicaidWA
1015751MedicaidAK

Other names 1

  • Dr. Jonathan Richard Elliott McDonagh Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jmcdonagh551266@ak.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK, TX2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20061101000273 AK Practitioner - Peripheral Vascular DiseasePractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal MedicinePractitioner - Vascular SurgeryPractitioner - Interventional Cardiology 9638113947 Reassigns benefits to 5 organizations
I20160308000809 TX Practitioner - Peripheral Vascular DiseasePractitioner - Cardiovascular Disease (Cardiology) 9638113947 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Peripheral Vascular DiseaseAlso: Cardiovascular Disease (Cardiology), Interventional Cardiology
Education
University of Vermont College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health and Services WashingtonGroup PAC ID 5799675120, 32 clinicians
Providence Health and Services WashingtonGroup PAC ID 2163335746, 32 clinicians
Alaska Heart InstituteGroup PAC ID 2668371469, 58 clinicians

Practice addresses (Care Compare)

1915 E Rezanof Dr
Kodiak, AK 99615-6602
Phone (907) 486-3281

3200 Providence Dr
Anchorage, AK 99508-4615
Phone (907) 562-2211

3841 Piper St
Suite T100
Anchorage, AK 99508-4674
Phone (907) 561-3211

Hospital & facility affiliations

  • Providence Alaska Medical Center Hospital, Anchorage, AK, CCN 020001
  • Alaska Regional Hospital Hospital, Anchorage, AK, CCN 020017
  • Central Peninsula General Hospital Hospital, Soldotna, AK, CCN 020024
  • South Peninsula Hospital Hospital, Homer, AK, CCN 021313
  • Providence Kodiak Island Medical Ctr Hospital, Kodiak, AK, CCN 021306

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
91.39
Promoting interoperability
95
Improvement activities
40
Cost
100

Merit-based Incentive Payment System (MIPS)

Final score
88.88 of 100Reported as apm
Quality
71.03
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
70.59 of 100Reported as group
Quality
83.37
Promoting interoperability
100
Improvement activities
40
Cost
16.65

Merit-based Incentive Payment System (MIPS)

Final score
76.58 of 100Reported as group
Quality
74.05
Improvement activities
40
Cost
56.66

Merit-based Incentive Payment System (MIPS)

Final score
90.93 of 100Reported as group
Quality
70.1
Promoting interoperability
100
Improvement activities
40
Cost
83.01

Procedures performed for Medicare patients

ProcedureNumber of procedures
Coronary angioplasty and stenting80
Leg revascularization (restoring blood flow)1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301097900MIMDInternal Medicine Physician
5821AKMDInterventional Cardiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince Nov 1, 2015 Accepting new patients
Providence Health & Services Washington CurrentSince Sep 1, 2019 Accepting new patients
South Peninsula Hospital, Inc Cardiovascular Disease CurrentSince May 2, 2018 Accepting new patients
South Peninsula Hospital, Inc. Internal Medicine CurrentSince May 2, 2018 Accepting new patients
Alaska Heart Institute CurrentSince Sep 22, 2015 Accepting new patients
Alaska Heart Institute Cardiovascular Disease CurrentSince Sep 22, 2015 Accepting new patients
Providence Health & Services Washington Current Accepting new patients
Alaska Native Tribal Health Consortium CurrentSince Jan 10, 2016 Accepting new patients
Providence Health & Services - Washington Cardiovascular Disease CurrentSince Sep 1, 2019 Accepting new patients
South Sound Inpatient Physicians PLLC Internal Medicine Past Accepting new patients
Providence Health & Services Washington Past Accepting new patients

Locations

3841 Piper St
Ste T100
Anchorage, AK 99508
Phone (907) 550-2233

3220 Providence Dr
Ste E3
Anchorage, AK 99508
Phone (907) 770-3750

2751 Debarr Rd
Ste B200
Anchorage, AK 99508

4315 Diplomacy Dr
Anchorage, AK 99508
Phone (907) 729-1729

3200 Providence Dr
Anchorage, AK 99508
Phone (907) 261-3111

4300 Bartlett St
Homer, AK 99603
Phone (907) 235-0369

1915 E Rezanof Dr
Kodiak, AK 99615
Phone (907) 486-3281

250 Hospital Pl
Soldotna, AK 99669
Phone (907) 714-4404

Organizations & group practices 12

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 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1972609949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 200149",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995200149",
            "telephone_number": "907-561-3211",
            "fax_number": "907-771-6870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3841 PIPER ST",
            "address_2": "SUITE T-100",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "995084624",
            "telephone_number": "907-561-3211",
            "fax_number": "907-771-6870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONAGH",
        "first_name": "JONATHAN",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4301097900",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "AK",
            "license": "5821",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "AK",
            "license": "5821",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "AK",
            "license": "5821",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8424384",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1015751",
            "state": "AK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jmcdonagh551266@ak.providencedirect.org",
            "affiliation": "N",
            "address_1": "3841 Piper St",
            "address_2": "Suite T-100",
            "city": "Anchorage",
            "state": "AK",
            "country_code": "US",
            "postal_code": "995084624",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "JONATHAN",
            "last_name": "ELLIOTT MCDONAGH",
            "middle_name": "RICHARD",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Anchorage, AK

Sources for this page

Verify at the official NPI Registry.