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MARK G MACDONALD MD
NPI 1124080791
Family Medicine in Saint Paul, MN

Active since April 06, 2006PECOS EnrolledAccepts Medicare Assignment
86.51/100
CMS Quality Rating
1700 UNIVERSITY AVE W FL 1, SAINT PAUL, MN 55104(651) 232-2002(651) 232-2031 Get Directions Write a Review

NPPES record last updated: October 22, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mark G Macdonald Md NPPES

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

MARK G MACDONALD MD (NPI 1124080791) is an individual family medicine provider in Saint Paul, Minnesota, licensed in Minnesota (40313) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS, is affiliated with Park Nicollet Methodist Hospital, and is a graduate of University Of New England, College Of Osteo Medicine (1996).

NPPES Registry Identity

NPI1124080791
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameMARK G MACDONALDCredential: MD
Location Address1700 UNIVERSITY AVE W FL 1Saint Paul, MN 55104-3727
Mailing Address1690 University Ave W, Suite 460Saint Paul, MN 55104-3723 · (651) 232-2002 · Fax (651) 232-2031
Phone(651) 232-2002
Fax(651) 232-2031
Sole ProprietorYes
Medical School CMSUniversity Of New England, College Of Osteo MedicineGraduated 1996
Enumeration DateApril 6, 2006
Last NPPES UpdateOctober 22, 2018
✔ NPI 1124080791 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in MN · 40313
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1700 UNIVERSITY AVE W FL 1, Saint Paul, MN 55104
Open in Google Maps ↗

Other Identifiers 1

Medicaid848182200MN

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mark G Macdonald Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6305824129
PECOS Enrollment IDI20040708001463
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Subsequent nursing facility care with moderate level of medical decision making, per day, if using time, at least 30 minutes 99309
A follow-up nursing facility visit per day is a daily check-in by a healthcare professional. This 25-minute visit typically involves monitoring your health progress, addressing any concerns, and adjusting treatment plans as necessary. It's a vital part of ensuring your ongoing wellbeing.
270 services157 patients
Initial nursing facility care with moderate level of medical decision making, per day, if using time, at least 35 minutes 99305
An initial nursing facility visit per day is a service where a healthcare professional spends about 35 minutes assessing a patient's health status. This includes reviewing medical history, conducting a physical exam, and developing a care plan based on the patient's needs.
143 services138 patients
Initial nursing facility care with high level of medical decision making, per day, if using time, 50 minutes or more 99306
An initial nursing facility visit is your first meeting with your healthcare team at a nursing facility. Lasting typically 45 minutes, this appointment involves a comprehensive health assessment and the creation of your personalized care plan. It's a crucial step to ensure your health and well-being.
37 services36 patients
Subsequent nursing facility care with high level of medical decision making, per day, if using time, at least 45 minutes 99310
A follow-up nursing facility visit is a routine check-up that typically lasts about 35 minutes. During this visit, your health status is evaluated, any changes in your condition are noted, and necessary adjustments to your care plan are made. It's an essential part of maintaining your health.
27 services24 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Park Nicollet Methodist Hospital

Acute Care Hospitals · Saint Louis Park, MN
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number240053
Location6500 Excelsior BlvdSaint Louis Park, MN 55426 · Hennepin County
Emergency services Birthing friendly

Essentia Health Virginia

Acute Care Hospitals · Virginia, MN
OwnershipGovernment - Local
CMS Certification Number240084
Location901 9th Street NorthVirginia, MN 55792 · St. Louis County
Birthing friendly

Essentia Health Deer River

Critical Access Hospitals · Deer River, MN
OwnershipVoluntary non-profit - Private
CMS Certification Number241360
Location115 10th Avenue NortheastDeer River, MN 56636 · Itasca County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55104 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
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$98.61 typical visit price
range $18.32 – $138.04
Typical copayment $24.65 (range $4.58 – $34.51)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

86.51/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality82.59
Promoting Interoperability100
Improvement Activities40
Cost67.96

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260
DME-Hospital Beds · category DB000N
2 suppliers23 claims23 services$41.62 avg. paid by Medicare
Standard wheelchair K0001
DME-Wheelchairs · category DD000N
3 suppliers44 claims44 services$16.91 avg. paid by Medicare
Elevating leg rests, pair (for use with capped rental wheelchair base) K0195
DME-Wheelchairs · category DD021N
2 suppliers16 claims16 services$8.55 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 4

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

FAIRVIEW CLINICS
Clinic/Center (Health Service)
1700 UNIVERSITY AVE W FL 1
SAINT PAUL, MN 55104
Ramsey County (952) 836-3637
NICOLE MARIE SIDDONS DNP, RN, APRN, FNP-C
Nurse Practitioner (Family)
1700 UNIVERSITY AVE W FL 1
SAINT PAUL, MN 55104
Ramsey County (651) 232-2002
MICHAEL HELFMAN
Nurse Practitioner (Gerontology)
1700 UNIVERSITY AVE W FL 1
SAINT PAUL, MN 55104
Ramsey County (651) 232-2022
DEANNA MARIE HEINE CNP
Nurse Practitioner (Adult Health)
1700 UNIVERSITY AVE W FL 1
SAINT PAUL, MN 55104
Ramsey County (651) 232-2002

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 Mark Macdonald's NPI number?

The NPI number for Mark Macdonald is 1124080791. It was assigned to this individual provider in the NPPES registry on April 6, 2006.

Where is Mark Macdonald located?

Mark Macdonald practices at 1700 University Ave W Fl 1, Saint Paul, MN 55104. The listed phone number is (651) 232-2002.

What is Mark Macdonald's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Mark Macdonald enrolled in Medicare?

Yes. Mark Macdonald is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Mark Macdonald accept?

Health plans from Medica list Mark Macdonald 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.

Is Mark Macdonald affiliated with any hospitals?

According to CMS data, Mark Macdonald is affiliated with Park Nicollet Methodist Hospital, Essentia Health Virginia and Essentia Health Deer River.

When was this NPI record last updated?

The NPPES record for Mark Macdonald was last updated on October 22, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.