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LEAH JEAN MCDONALD M.D.
NPI 1417335423
Emergency Medicine - Hospice and Palliative Medicine in Providence, RI

Active since May 11, 2015PECOS EnrolledAccepts Medicare Assignment
97.38/100
CMS Quality Rating
1085 N MAIN ST, PROVIDENCE, RI 02904(401) 415-4618(401) 415-4348 Get Directions Write a Review

NPPES record last updated: August 6, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Aug 6, 2020, Nov 26, 2019 (2 updates tracked since 2019).

About Leah Jean Mcdonald M.d. NPPES

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

LEAH JEAN MCDONALD M.D. (NPI 1417335423) is an individual hospice and palliative medicine provider in Providence, Rhode Island, licensed in Rhode Island (MD16818) and active in the NPI registry since May 2015. She is enrolled in Medicare PECOS, is affiliated with Falmouth Hospital, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1417335423
Entity TypeIndividualFemale
Primary Taxonomy207PH0002X
Provider Legal NameLEAH JEAN MCDONALDCredential: M.D.
Location Address1085 N MAIN STProvidence, RI 02904-5719
Mailing Address1085 N Main StProvidence, RI 02904-5719 · (401) 415-4618 · Fax (401) 415-4348
Phone(401) 415-4618
Fax(401) 415-4348
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateMay 11, 2015
Last NPPES UpdateAugust 6, 20202 updates tracked since enumeration
NPPES CertifiedAugust 6, 2020
✔ NPI 1417335423 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEmergency Medicine · Hospice and Palliative MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207PH0002X
License✔ Licensed in RI · MD16818
Definition
An emergency medicine physician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This specialist works with an interdisciplinary hospice or palliative care team to maximize quality of life while addressing physical, psychological, social and spiritual needs of both patient and family throughout the course of the disease, through the dying process, and beyond for the family. This specialist has expertise in the assessment of patients with advanced disease; the relief of distressing symptoms; the coordination of interdisciplinary patient and family-centered care in diverse venues; the use of specialized care systems including hospice; the management of the imminently dying patient; and legal and ethical decision making in end-of-life care.
Also ListedEmergency MedicineTaxonomy 207P00000X · License MD16818 (RI)
1085 N MAIN ST, Providence, RI 02904
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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

Leah Jean Mcdonald M.d. 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 ID5496092389
PECOS Enrollment IDI20191105001184, I20200819003121
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

5

Medicare enrollment records show Leah Mcdonald reassigns Medicare billing to 5 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Hopehealth Hospice & Palliative Care
Same address
Case Management
1085 N MAIN ST
Providence, RI 02904
  • Reassigned Medicare billing, Rhode Island enrollment
  • 62 clinicians in this Medicare group
NPI 1790851590 (401) 415-4230
Lifespan Physician Group Inc
0.4 mi
Urology
195 COLLYER ST STE 201
Providence, RI 02904
  • Reassigned Medicare billing, Rhode Island enrollment
  • 1,372 clinicians in this Medicare group
NPI 1720949803 (401) 272-7799
Brown Emergency Medicine
2.7 mi
Emergency Medicine
593 EDDY ST, CLAVERICK 2
Providence, RI 02903
  • Reassigned Medicare billing, Rhode Island enrollment
  • 201 clinicians in this Medicare group
NPI 1962455022 (401) 444-4000
Emergency Physicians Of Falmouth
45 mi
Emergency Medicine
100 TER HEUN DR
Falmouth, MA 02540
  • Reassigned Medicare billing, Massachusetts enrollment
  • 51 clinicians in this Medicare group
NPI 1376828988 (781) 280-1699
Urgi Center Medical Group
48 mi
Urgent Care
2 JAN SEBASTIAN DR, 100
Sandwich, MA 02563
  • Reassigned Medicare billing, Massachusetts enrollment
  • 129 clinicians in this Medicare group
NPI 1902146798 (508) 833-2639

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 6

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.

Advance care planning, first 30 minutes 99497
Advance care planning is a process where you discuss your healthcare preferences with your doctor. This conversation, lasting up to 30 minutes, helps ensure your wishes are respected if you're unable to communicate them in the future. It's about your care, your way.
164 services153 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.
148 services143 patients
Emergency department visit with high level of medical decision making 99285
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
128 services126 patients
Emergency department visit with moderate level of medical decision making 99284
An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
32 services32 patients
Advance care planning, each additional 30 minutes 99498
Advance care planning involves discussing and documenting your future health care preferences in case you're unable to make decisions for yourself. Each additional 30 minutes allows more time to explore your wishes, values, and goals for treatment.
27 services14 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
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.

Falmouth Hospital

Acute Care Hospitals · Falmouth, MA
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220135
Location67 & 100 Ter Heun DriveFalmouth, MA 02540 · Barnstable County
Emergency services

Rhode Island Hospital

Acute Care Hospitals · Providence, RI
3/5 CMS rating
OwnershipTribal
CMS Certification Number410007
Location593 Eddy StreetProvidence, RI 02903 · Providence County
Emergency services

The Miriam Hospital

Acute Care Hospitals · Providence, RI
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number410012
Location164 Summit AvenueProvidence, RI 02906 · Providence County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02904 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
$90.48 typical visit price
range $58.57 – $177.03
Typical copayment $22.62 (range $14.64 – $44.25)
Most-billed visit code 99203
Established Patient
$103.10 typical visit price
range $18.92 – $144.38
Typical copayment $25.77 (range $4.73 – $36.09)
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.

97.38/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality93.56
Promoting Interoperability100
Improvement Activities40

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.

MS. SARAH PAGLIARINI NP
Nurse Practitioner (Family)
1085 N MAIN ST
PROVIDENCE, RI 02904
Providence County (401) 415-4200
JULIE MAZZA DO
Internal Medicine (Hospice and Palliative Medicine)
1085 N MAIN ST
PROVIDENCE, RI 02904
Providence County (401) 415-4200
TIMOTHY POORE M.D.
Internal Medicine (Hospice and Palliative Medicine)
1085 N MAIN ST
PROVIDENCE, RI 02904
Providence County (401) 415-4200
DR. EMILY CAITLIN WHITE MD
Family Medicine (Hospice and Palliative Medicine)
1085 N MAIN ST
PROVIDENCE, RI 02904
Providence County (401) 415-4200
NISHITHA REDDY M.D.
Internal Medicine (Hospice and Palliative Medicine)
1085 N MAIN ST
PROVIDENCE, RI 02904
Providence County (401) 415-4618
EMILY ALVES NP
Nurse Practitioner
1085 N MAIN ST
PROVIDENCE, RI 02904
Providence County (844) 671-4673
KARINA SANTOS NP
Nurse Practitioner (Acute Care)
1085 N MAIN ST
PROVIDENCE, RI 02904
Providence County (401) 415-4618
BETHANY ANN BURROWS SHEAHAN NP
Nurse Practitioner (Acute Care)
1085 N MAIN ST
PROVIDENCE, RI 02904
Providence County (401) 415-4618

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 Leah Mcdonald's NPI number?

The NPI number for Leah Mcdonald is 1417335423. It was assigned to this individual provider in the NPPES registry on May 11, 2015.

Where is Leah Mcdonald located?

Leah Mcdonald practices at 1085 N Main St, Providence, RI 02904. The listed phone number is (401) 415-4618.

What is Leah Mcdonald's specialty?

The primary specialty registered for this NPI is Emergency Medicine, specializing in Hospice and Palliative Medicine, with taxonomy code 207PH0002X.

Is Leah Mcdonald enrolled in Medicare?

Yes. Leah 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 Leah Mcdonald's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Leah Mcdonald reassigns Medicare benefits to 5 organizations: Hopehealth Hospice & Palliative Care (Providence, RI), Lifespan Physician Group Inc (Providence, RI), Brown Emergency Medicine (Providence, RI), Emergency Physicians Of Falmouth (Falmouth, MA) and Urgi Center Medical Group (Sandwich, MA). 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 Leah Mcdonald's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Leah Mcdonald affiliated with any hospitals?

According to CMS data, Leah Mcdonald is affiliated with Falmouth Hospital, Rhode Island Hospital and The Miriam Hospital.

When was this NPI record last updated?

The NPPES record for Leah Mcdonald was last updated on August 6, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.