DR. MATTHEW C MCDONNELL, M.D. - NPI NUMBER 1841291507

Summary

Provider Name: DR. MATTHEW C MCDONNELL, M.D.

NPI Number: 1841291507

Clasification: Otolaryngology (207Y00000X)

Organization: THE CLEVELAND CLINIC FOUNDATION

Address:
970 EAST WASHINGTON STREET
SUITE 6A
MEDINA, OH
ZIP 44256

Phone Number: (330) 723-6673



Detailed Information

DR. Matthew C Mcdonnell, M.D. is an otolaryngologist in Medina, OH with 29 years of experience. The provider is an otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. The assigned NPI number for this provider is 1841291507 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: MEDICAL COLLEGE OF OHIO AT TOLEDO
Graduation Year: 1986

The provider's business address is:

970 EAST WASHINGTON STREET
SUITE 6A
MEDINA, OH
ZIP 44256
Phone: (330) 723-6673
Fax: (330) 764-9832

The enumeration date for this NPI number is 8/3/2005 and was last updated on 3/12/2012.

Map - Location of Practice

Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 207Y00000X Otolaryngology 35059577 OH No
2 207Y00000X Otolaryngology 35-05-9577 OH Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 E92009 MEDICARE UPIN OH
2 0828886 MEDICAID OH
3 MC4038063 MEDICARE PIN OH

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1841291507 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 1 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Provider Last Name Legal Name MCDONNELL The last name of the provider. If the provider is an individual, this is the legal name.
4 Provider First Name MATTHEW The first name of the provider, if the provider is an individual.
5 Provider Middle Name C The middle name of the provider, if the provider is an individual.
6 Provider Name Prefix Text DR. The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
7 Provider Credential Text M.D. The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
8 Provider First Line Business Practice Location Address 970 EAST WASHINGTON STREET The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
9 Provider Second Line Business Practice Location Address SUITE 6A The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
10 Provider Business Practice Location Address City Name MEDINA The city name in the location address of the provider being identified.
11 Provider Business Practice Location Address State Name OH The State code in the location of the provider being identified.
12 Provider Business Practice Location Address Postal Code 44256 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
13 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
14 Provider Business Practice Location Address Telephone Number 3307236673 The telephone number associated with the location address of the provider being identified.
15 Provider Business Practice Location Address Fax Number 3307649832 The fax number associated with the location address of the provider being identified.
16 Provider Enumeration Date 8/3/2005 The date the provider was assigned a unique identifier (assigned an NPI).
17 Last Update Date 3/12/2012 The date that a record was last updated or changed.
18 Provider Gender Code M The code designating the provider’s gender if the provider is a person.
19 Healthcare Provider Taxonomy Code 1 207Y00000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
20 Provider License Number 1 35059577 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
21 Provider License Number State Code 1 OH The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
22 Healthcare Provider Primary Taxonomy Switch 1 N
23 Healthcare Provider Taxonomy Code 2 207Y00000X
24 Provider License Number 2 35-05-9577 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
25 Provider License Number State Code 2 OH The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
26 Healthcare Provider Primary Taxonomy Switch 2 Y
27 Other Provider Identifier 1 E92009 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
28 Other Provider Identifier Type Code 1 02 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
29 Other Provider Identifier State 1 OH
30 Other Provider Identifier 2 0828886 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
31 Other Provider Identifier Type Code 2 05 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
32 Other Provider Identifier State 2 OH
33 Other Provider Identifier 3 MC4038063 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
34 Other Provider Identifier Type Code 3 08 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
35 Other Provider Identifier State 3 OH
36 Is Sole Proprietor N Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No

Similar Providers Nearby

NPI Provider Name NPI Type Taxonomy
1902039050 UNIVERSITY HOSPITALS MEDICAL GROUP, INC. Organization Otolaryngology


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This page was last updated on: 4/19/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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