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DR. THOMAS JAMES MCDONALD III D.M.D.
NPI 1093072613
Dentist - Oral and Maxillofacial Surgery in Toms River, NJ

Active since April 20, 2012Opted out of Medicare · through Oct 28, 2027
20 HOSPITAL DR STE 14, TOMS RIVER, NJ 08755(732) 349-8400(732) 473-9655 Get Directions Write a Review

NPPES record last updated: August 17, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 17, 2023, Aug 13, 2019, Apr 29, 2019 and 1 more (4 updates tracked since 2016).

About Dr. Thomas James Mcdonald Iii D.m.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. THOMAS JAMES MCDONALD III D.M.D. (NPI 1093072613) is an individual oral and maxillofacial surgery provider in Toms River, New Jersey, licensed in New Jersey (22DI02630900) and active in the NPI registry since April 2012. He has opted out of Medicare through October 28, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1093072613
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. THOMAS JAMES MCDONALD IIICredential: D.M.D.
Location Address20 HOSPITAL DR STE 14Toms River, NJ 08755-6434
Mailing Address20 Hospital Dr Ste 14Toms River, NJ 08755-6434 · (732) 349-8400
Phone(732) 349-8400
Fax(732) 473-9655
Sole ProprietorNo
Enumeration DateApril 20, 2012
Last NPPES UpdateAugust 17, 20234 updates tracked since enumeration
NPPES CertifiedMay 6, 2022
✔ NPI 1093072613 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in NJ · 22DI02630900
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
20 HOSPITAL DR STE 14, Toms River, NJ 08755
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BEST Life, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Thomas James Mcdonald Iii D.m.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 28, 2017 through October 28, 2027.

Opt-Out Effective DateOctober 28, 2017
Opt-Out In Effect ThroughOctober 28, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 08755 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$94.90 typical visit price
range $61.59 – $185.05
Typical copayment $23.72 (range $15.39 – $46.26)
Most-billed visit code 99203
Established Patient
$76.45 typical visit price
range $20.08 – $150.98
Typical copayment $19.11 (range $5.02 – $37.74)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

OCEAN COUNTY ORAL AND MAXILLOFACIAL SURGERY
Dentist (Oral and Maxillofacial Surgery)
20 HOSPITAL DR STE 14
TOMS RIVER, NJ 08755
Ocean County (732) 349-8400

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Thomas Mcdonald's NPI number?

The NPI number for Thomas Mcdonald is 1093072613. It was assigned to this individual provider in the NPPES registry on April 20, 2012.

Where is Thomas Mcdonald located?

Thomas Mcdonald practices at 20 Hospital Dr Ste 14, Toms River, NJ 08755. The listed phone number is (732) 349-8400.

What is Thomas Mcdonald's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Thomas Mcdonald enrolled in Medicare?

No. Thomas Mcdonald has opted out of Medicare through October 28, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Thomas Mcdonald accept?

Health plans from BEST Life, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 6 other insurers list Thomas Mcdonald as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Thomas Mcdonald was last updated on August 17, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.