DEREK JAMES DONEGAN MD
NPI 1295895159
Orthopaedic Surgery in Philadelphia, PA

Q: What is Derek Donegan's NPI number?

The NPI number for Derek Donegan is 1295895159. It was assigned to this individual provider in the NPPES registry on December 11, 2006.

Q: What is Derek Donegan's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Q: When was this NPI record last updated?

The NPPES record for Derek Donegan was last updated on March 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.

Active since December 11, 2006PECOS EnrolledAccepts Medicare Assignment

85.48/100

CMS Quality Rating

3737 MARKET ST, 7TH FLOOR, PHILADELPHIA, PA 19104(215) 662-3340(215) 222-8875 Get Directions Write a Review

NPPES record last updated: March 10, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Derek James Donegan Md NPPES

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

DEREK JAMES DONEGAN MD (NPI 1295895159) is an individual orthopaedic surgery provider in Philadelphia, Pennsylvania, licensed in Pennsylvania (MD436412) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS, is affiliated with Hospital Of Univ Of Pennsylvania, and is a graduate of Jefferson Medical College Of Thomas Jefferson University (2006).

NPPES Registry Identity

NPI1295895159

Entity TypeIndividualMale

Primary Taxonomy207X00000X

Provider Legal NameDEREK JAMES DONEGANCredential: MD

Location Address3737 MARKET ST, 7TH FLOORPhiladelphia, PA 19104-5545

Mailing Address3737 Market St, 7th FloorPhiladelphia, PA 19104-5545 · (215) 662-3340 · Fax (215) 222-8875

Phone(215) 662-3340

Fax(215) 222-8875

Sole ProprietorNo

Medical School CMSJefferson Medical College Of Thomas Jefferson UniversityGraduated 2006

Enumeration DateDecember 11, 2006

Last NPPES UpdateMarch 10, 2026

NPPES CertifiedMarch 10, 2026

✔ NPI 1295895159 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians

Taxonomy Code207X00000X

Licenses✔ Licensed in PA · MD436412✔ Licensed in NJ · 25MA08965100

Definition

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

3737 MARKET ST, Philadelphia, PA 19104

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter Health of Delaware.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

Derek James Donegan 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 ID648426619

PECOS Enrollment IDI20120807000328

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.

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

91 services70 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

58 services51 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

43 services43 patients

Treatment of broken neck of thigh bone with bone implant 27245

This procedure involves repairing a fractured thigh bone by inserting a bone implant. The implant helps stabilize the bone, allowing it to heal correctly. It's performed under anesthesia and requires a hospital stay for recovery.

14 services14 patients

Hospital Affiliations CMS Care Compare 3

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

Hospital Of Univ Of Pennsylvania

Acute Care Hospitals · Philadelphia, PA

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390111

Location34th & Spruce StsPhiladelphia, PA 19104 · Philadelphia County

Emergency services Birthing friendly

Penn Presbyterian Medical Center

Acute Care Hospitals · Philadelphia, PA

5/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number390223

Location51 North 39th StreetPhiladelphia, PA 19104 · Philadelphia County

Emergency services

Pennsylvania Hospital

Acute Care Hospitals · Philadelphia, PA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number390226

Location800 Spruce StreetPhiladelphia, PA 19107 · Philadelphia County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19104 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

$92.69 typical visit price

range $59.88 – $180.99

Typical copayment $23.17 (range $14.97 – $45.24)

Most-billed visit code 99203

Established Patient

$74.47 typical visit price

range $19.30 – $147.29

Typical copayment $18.61 (range $4.82 – $36.82)

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.

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.

85.48/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

73.6

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 2

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

Lightweight wheelchair K0003

DME-Wheelchairs · category DD000N

1 supplier15 claims15 services$20.08 avg. paid by Medicare

Elevating leg rests, pair (for use with capped rental wheelchair base) K0195

DME-Wheelchairs · category DD021N

1 supplier15 claims15 services$6.44 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.

SAMIR MEHTA MD

Orthopaedic Surgery

3737 MARKET ST, 7 FLOOR
PHILADELPHIA, PA 19104

Philadelphia County (215) 662-3340

GINA MARIA MCGARVEY PA-C

Physician Assistant

3737 MARKET ST
PHILADELPHIA, PA 19104

Philadelphia County (267) 575-3110

MICHAEL MALONEY

Family Medicine

3737 MARKET ST, 9TH FL
PHILADELPHIA, PA 19104

Philadelphia County (215) 662-8777

DR. JEREMY B KATZEN M.D.

Internal Medicine (Pulmonary Disease)

3737 MARKET ST, 10TH FL
PHILADELPHIA, PA 19104

Philadelphia County (215) 662-3202

CRAIG D KATZ PA-C

Physician Assistant

3737 MARKET ST, 7TH FLOOR
PHILADELPHIA, PA 19104

Philadelphia County (215) 662-3340

PRISCILLA ESADAH MD

Family Medicine

3737 MARKET ST, 9TH FLOOR
PHILADELPHIA, PA 19104

Philadelphia County (215) 662-8777

LAUREN ANNE SMITH CRNP

Nurse Practitioner (Family)

3737 MARKET ST, 7TH FLOOR
PHILADELPHIA, PA 19104

Philadelphia County (215) 662-3340

ALYSSA KATHLEEN BRUEHLMAN M.D.

Family Medicine (Addiction Medicine)

3737 MARKET ST, 9TH FL
PHILADELPHIA, PA 19104

Philadelphia County (215) 662-8777

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 Derek Donegan's NPI number?

The NPI number for Derek Donegan is 1295895159. It was assigned to this individual provider in the NPPES registry on December 11, 2006.

Where is Derek Donegan located?

Derek Donegan practices at 3737 Market St 7th Floor, Philadelphia, PA 19104. The listed phone number is (215) 662-3340.

What is Derek Donegan's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Derek Donegan enrolled in Medicare?

Yes. Derek Donegan 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 Derek Donegan accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan list Derek Donegan 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 Derek Donegan affiliated with any hospitals?

According to CMS data, Derek Donegan is affiliated with Hospital Of Univ Of Pennsylvania, Penn Presbyterian Medical Center and Pennsylvania Hospital.

When was this NPI record last updated?

The NPPES record for Derek Donegan was last updated on March 10, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.