John Dermott McGonigle, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD12897 Issued in RI

Practice address

201 Waterman Ave
East Providence, RI 02914-3522

Phone

(401) 572-3300

Fax

(401) 572-3301

NPI assigned

Aug 16, 2006

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 RI

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

Specialty

Family Practice

Education

State University of New York at Stony Brook, School of Medicine, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Miriam Hospital Hospital, Providence, RI, CCN 410012

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• John McGonigle MD LLC

  • Family Medicine Physician
  • East Providence, RI
  • NPI 1396320057
  Medicare reassignment NPD Authorized official
• Providence Integrative Wellness

  • Pediatrics Physician
  • Providence, RI
  • NPI 1609001585
  NPD (past)

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

• The Miriam Hospital

  • General Acute Care Hospital
  • Providence, RI
  • NPI 1487649430
  Care Compare affiliation

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615852800000",
    "number": "1982717807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 WATERMAN AVE",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029143522",
            "telephone_number": "401-572-3300",
            "fax_number": "401-572-3301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 WATERMAN AVE",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029143522",
            "telephone_number": "401-572-3300",
            "fax_number": "401-572-3301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGONIGLE",
        "first_name": "JOHN",
        "middle_name": "DERMOTT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "MD12897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexa C McCue, DPT
• Meghan McDermott, BA
• Michael McGee, D.P.T.
• Kirsten D McGinn, EARLY CHILD EDU - SC
• Karen McGoldrick, MD
• Edward McGookin, MD
• Maria Louise McGurrin
• Lionel McIntosh, M.D.
• Jill Ann McKenna Bailey, APRN
• Morgan F McKenney, DPT

• Family Medicine Physician in East Providence, RI
• Providers in East Providence, RI by specialty
• Family Medicine Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.