DR. DOUGLAS MCDONALD M.D.
NPI 1366426249
Family Medicine in Redmond, WA
NPI Status: Active since December 03, 2005
Contact Information
15670 REDMOND WAY
REDMOND, WA
ZIP 98052
Phone: (206) 320-5190
Fax: (206) 320-5191
- Individual
- Male
- Family Medicine
- Accepts Insurance
- Opted-Out Medicare
About DOUGLAS MCDONALD
This page provides the complete NPI Profile along with additional information for Douglas Mcdonald, a primary care provider established in Redmond, Washington with a medical specialization in Family Medicine. The healthcare provider is registered in the NPI registry with number 1366426249 assigned on December 2005. The practitioner's primary taxonomy code is 207Q00000X with license number 22624 (WA). The provider is registered as an individual and his NPI record was last updated 6 years ago.
- NPI
- 1366426249
- Provider Name
- DR. DOUGLAS MCDONALD M.D.
- Other Name
- DR. G. DOUGLAS MCDONALD MD
- Other Name Type
- Professional Name (2)
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 15670 REDMOND WAY REDMOND, WA 98052
- Location Phone
- (206) 320-5190
- Location Fax
- (206) 320-5191
- Mailing Address
- PO BOX 84026 SEATTLE, WA 98124
- Mailing Phone
- (206) 320-4476
- Mailing Fax
- (206) 320-5191
- Is Sole Proprietor?
- No
- Enumeration Date
- 12-03-2005
- Last Update Date
- 10-08-2020
- Code Navigator
A primary care provider (PCP) like Douglas Mcdonald sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Douglas Mcdonald opted out of Medicare effective on 10-10-2024 until 10-10-2026. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare and cannot order and refer services to other healthcare providers.
Location Map
Secondary Locations
- 18100 NE Union Hill Rd Ste 200
Redmond, WA 98052
(425) 498-2246
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 22624
- License State
- WA
- Taxonomy Description
- 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.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Core Bronze HSA 10600 - EPO
- Core Bronze HSA 7500 - EPO
- Core Bronze HSA 8300 - EPO
- Core Gold 1500 - EPO
- Core Gold 3000 - EPO
- Core Silver 3500 - EPO
- Core Silver 4500 - EPO
- Core Silver 5000 - EPO
- Core Silver 7500 - EPO
- Core Standard Expanded Bronze HSA - EPO
- Core Standard Gold - EPO
- Core Standard Silver - EPO
- PacificSource Oregon Standard Bronze HSA Plan Core - EPO
- PacificSource Oregon Standard Gold Plan Core - EPO
- PacificSource Oregon Standard Silver Plan Core - EPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1006675 | MEDICAID (05) | WA | |
| 104494 | OTHER (01) | WA | LABOR & INDUSTRIES |
Medicare Participation & PECOS Enrollment Status
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 10-10-2024
Opt-Out End Date: 10-10-2026
Eligible to Order and Refer? No
Reviews for DR. DOUGLAS MCDONALD M.D.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1366426249, we treat the final digit (9) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 61. The final step is to find the difference between that total and the next multiple of ten (70 - 61 = 9).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 61 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1366426249, enumerated as an "individual" on December 03, 2005.
The provider is located at 15670 REDMOND WAY REDMOND, WA 98052 and the phone number is (206) 320-5190.
Family Medicine with taxonomy code 207Q00000X.
The provider might be accepting Accepts: PacificSource Health Plans, Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
