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THOMAS C MCDONALD MD
NPI 1124098488
Internal Medicine in Lexington, TN

Active since January 26, 2006PECOS EnrolledAccepts Medicare Assignment
48.71/100
CMS Quality Rating
200 W CHURCH ST, LEXINGTON, TN 38351(731) 968-3646(731) 968-1870 Get Directions Write a Review

NPPES record last updated: June 14, 2024. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Thomas C Mcdonald Md NPPES

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

THOMAS C MCDONALD MD (NPI 1124098488) is an individual internal medicine provider in Lexington, Tennessee, licensed in Tennessee (23828) and active in the NPI registry since January 2006. He is enrolled in Medicare PECOS, is affiliated with Jackson-madison County General Hospital, and maintains 3 additional practice locations.

NPPES Registry Identity

NPI1124098488
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameTHOMAS C MCDONALDCredential: MD
Location Address200 W CHURCH STLexington, TN 38351-2038
Mailing Address200 W Church StLexington, TN 38351-2038 · (731) 968-3646 · Fax (731) 968-1870
Phone(731) 968-3646
Fax(731) 968-1870
Sole ProprietorNo
Medical School CMSUniversity Of Tennessee, Hsc, College Of MedicineGraduated 1994
Enumeration DateJanuary 26, 2006
Last NPPES UpdateJune 14, 2024
NPPES CertifiedJune 6, 2024
✔ NPI 1124098488 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 7

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in TN · 23828
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedEmergency MedicineTaxonomy 207P00000X · License 23838 (TN)
Also ListedFamily MedicineTaxonomy 207Q00000X · License 23828 (TN)
Also ListedPediatricsTaxonomy 208000000X · License 23828 (TN)
Also ListedPhysical Medicine & RehabilitationTaxonomy 208100000X · License 23838 (TN)
Also ListedRadiology · Diagnostic RadiologyTaxonomy 2085R0202X · License 23828 (TN)
Also ListedSurgeryTaxonomy 208600000X · License 23828 (TN)
200 W CHURCH ST, Lexington, TN 38351
Open in Google Maps ↗

Secondary Practice Locations 3

Location 1270 W Church St, Suite ALexington, TN 38351-2077 · Phone (731) 968-9965 · Fax (731) 968-1940
Location 25001 E Main StErin, TN 37061-4115 · Phone (336) 944-6420
Location 32545 N Washington AveBrownsville, TN 38012-1610 · Phone (931) 289-4211

Other Identifiers 1

Other4118454TN · Bcbs

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Thomas C Mcdonald 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 ID8527972603
PECOS Enrollment IDI20031113000353
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.

Medicare Billing Reassignments

6

Medicare enrollment records show Thomas Mcdonald reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Lexington Clinic Corp
Same address
Family Medicine
200 W CHURCH ST
Lexington, TN 38351
  • Reassigned Medicare billing, Tennessee enrollment
  • 48 clinicians in this Medicare group
NPI 1780652107 (731) 968-3646
Lexington Family Physicians LLC
Same address
Family Medicine
200 W CHURCH ST
Lexington, TN 38351
  • Reassigned Medicare billing, Tennessee enrollment
  • 47 clinicians in this Medicare group
NPI 1265660708 (731) 968-3646
Lexington Hospital Corporation
Same address
Emergency Medicine
200 W CHURCH ST
Lexington, TN 38351
  • Reassigned Medicare billing, Tennessee enrollment
  • 49 clinicians in this Medicare group
NPI 1407290893 (731) 968-4477
Perry County Community Hospital Inc
30 mi
Critical Access
2718 SQUIRREL HOLLOW DR
Linden, TN 37096
  • Reassigned Medicare billing, Tennessee enrollment
  • 27 clinicians in this Medicare group
NPI 1528890480 (731) 968-3646
Haywood County Community Hospital, Inc
48 mi
Emergency Medicine
2545 N WASHINGTON AVE
Brownsville, TN 38012
  • Reassigned Medicare billing, Tennessee enrollment
  • 42 clinicians in this Medicare group
NPI 1790444933 (731) 968-3646
Shamrock Community Hospital Inc
61 mi
Critical Access
5001 E MAIN ST
Erin, TN 37061
  • Reassigned Medicare billing, Tennessee enrollment
  • Also billed through NPI 1033878277 (Tennessee)
  • 33 clinicians in this Medicare group
NPI 1811566540 (731) 968-3646

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 hospital care with moderate levelof medical decision making, if using time, at least 50 minutes 99233
Follow-up hospital inpatient care per day typically involves a 35-minute check-up by your healthcare provider. This service includes monitoring your health progress, adjusting your treatment plan if needed, and answering any questions you may have about your condition or care.
540 services220 patients
Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
271 services233 patients
Hospital discharge day management, more than 30 minutes 99239
Hospital discharge day management over 30 minutes involves a detailed process to ensure a smooth transition from hospital to home. It includes final examinations, discussion of your hospital stay, post-discharge instructions, and coordinating follow-up care.
271 services232 patients
X-ray of chest, 1 view 71045
A chest X-ray, 1 view, is a quick, painless test that produces images of the structures within your chest, such as your heart, lungs, and blood vessels. It helps in diagnosing conditions like pneumonia, heart problems, or lung cancer. You'll stand in front of a machine that emits X-rays, which pass through your body to create the image.
21 services13 patients

Hospital Affiliations CMS Care Compare 2

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

Jackson-Madison County General Hospital

Acute Care Hospitals · Jackson, TN
3/5 CMS rating
OwnershipGovernment - Hospital District or Authority
CMS Certification Number440002
Location620 Skyline DriveJackson, TN 38301 · Madison County
Emergency services Birthing friendly

Henderson County Community Hospital

Acute Care Hospitals · Lexington, TN
OwnershipProprietary
CMS Certification Number440008
Location200 W Church StLexington, TN 38351 · Henderson County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 38351 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
$121.80 typical visit price
range $52.64 – $160.89
Typical copayment $30.45 (range $13.16 – $40.22)
Most-billed visit code 99204
Established Patient
$93.60 typical visit price
range $16.72 – $131.41
Typical copayment $23.40 (range $4.18 – $32.85)
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.

48.71/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality0
Improvement Activities20
Cost96.71

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.

Portable gaseous oxygen system, rental; includes portable container, regulator, flowmeter, humidifier, cannula or mask, and tubing E0431
DME-Oxygen and Supplies · category DC000N
4 suppliers69 claims69 services$18.55 avg. paid by Medicare
Oxygen concentrator, single delivery port, capable of delivering 85 percent or greater oxygen concentration at the prescribed flow rate E1390
DME-Oxygen and Supplies · category DC002N
6 suppliers110 claims110 services$103.73 avg. paid by Medicare
Portable oxygen concentrator, rental E1392
DME-Oxygen and Supplies · category DC002N
2 suppliers19 claims19 services$36.08 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 20

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

LEXINGTON HOSPITAL CORPORATION
Family Medicine
200 W CHURCH ST
LEXINGTON, TN 38351
Henderson County (731) 968-3646
LEXINGTON CLINIC CORP
Clinic/Center (Rural Health)
200 W CHURCH ST
LEXINGTON, TN 38351
Henderson County (731) 968-3646
LEXINGTON HOSPITAL CORPORATION
Medicare Defined Swing Bed Unit
200 W CHURCH ST
LEXINGTON, TN 38351
Henderson County (731) 968-3646
WILLOW EMERGENCY PHYSICIANS, LLC
Emergency Medicine
200 W CHURCH ST
LEXINGTON, TN 38351
Henderson County (973) 251-1132
AMBULANCE SERVICES OF LEXINGTON, INC.
Ambulance (Land Transport)
200 W CHURCH ST
LEXINGTON, TN 38351
Henderson County (731) 968-1845
ROBERT L WINSTON M.D.
Internal Medicine
200 W CHURCH ST
LEXINGTON, TN 38351
Henderson County (731) 968-3646
BEECHLAKE EMERGENCY PHYSICIANS
Emergency Medicine
200 W CHURCH ST
LEXINGTON, TN 38351
Henderson County (731) 968-3646
CHAD C SCOTT FNP MSN
Nurse Practitioner (Family)
200 W CHURCH ST
LEXINGTON, TN 38351
Henderson County (731) 968-3646

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 1124098488. It was assigned to this individual provider in the NPPES registry on January 26, 2006.

Where is Thomas Mcdonald located?

Thomas Mcdonald practices at 200 W Church St, Lexington, TN 38351. The listed phone number is (731) 968-3646.

What is Thomas Mcdonald's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Thomas Mcdonald enrolled in Medicare?

Yes. Thomas Mcdonald 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.

Which organizations bill Medicare for Thomas Mcdonald's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Thomas Mcdonald reassigns Medicare benefits to 6 organizations: Lexington Clinic Corp (Lexington, TN), Lexington Family Physicians LLC (Lexington, TN), Lexington Hospital Corporation (Lexington, TN), Perry County Community Hospital Inc (Linden, TN), Haywood County Community Hospital, Inc (Brownsville, TN) and 1 more organization, listed in the Medicare section above. Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Thomas Mcdonald's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Thomas Mcdonald accept?

Health plans from Cigna Healthcare 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.

Is Thomas Mcdonald affiliated with any hospitals?

According to CMS data, Thomas Mcdonald is affiliated with Jackson-Madison County General Hospital and Henderson County Community Hospital.

When was this NPI record last updated?

The NPPES record for Thomas Mcdonald was last updated on June 14, 2024. 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.