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DR. DENISE M DONAHUE M.D.
NPI 1518091867
Orthopaedic Surgery in West Reading, PA

Active since March 16, 2007PECOS EnrolledAccepts Medicare Assignment
71.04/100
CMS Quality Rating
301 S 7TH AVE, SUITE 3220, WEST READING, PA 19611(610) 376-8671(610) 376-6387 Get Directions Write a Review

NPPES record last updated: September 11, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Denise M Donahue M.d. NPPES

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

DR. DENISE M DONAHUE M.D. (NPI 1518091867) is an individual orthopaedic surgery provider in West Reading, Pennsylvania, licensed in Pennsylvania (MD033596E) and active in the NPI registry since March 2007. She is enrolled in Medicare PECOS, is affiliated with Reading Hospital, and is a graduate of Temple University School Of Medicine (1983).

NPPES Registry Identity

NPI1518091867
Entity TypeIndividualFemale
Primary Taxonomy207X00000X
Provider Legal NameDR. DENISE M DONAHUECredential: M.D.
Location Address301 S 7TH AVE, SUITE 3220West Reading, PA 19611-1410
Mailing Address301 S 7th Ave, Suite 3220West Reading, PA 19611-1410 · (610) 376-8671 · Fax (610) 376-6387
Phone(610) 376-8671
Fax(610) 376-6387
Sole ProprietorNo
Medical School CMSTemple University School Of MedicineGraduated 1983
Enumeration DateMarch 16, 2007
Last NPPES UpdateSeptember 11, 2014
✔ NPI 1518091867 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License✔ Licensed in PA · MD033596E
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.
301 S 7TH AVE, West Reading, PA 19611
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Other Identifiers 2

Medicare UPINC34402PA
Medicare PIN463039G7G

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

Dr. Denise M Donahue 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 ID9830296441
PECOS Enrollment IDI20070516000150
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 8

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.

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301
Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
398 services88 patients
Aspiration and/or injection of fluid large joint using ultrasound guidance 20611
This procedure involves using ultrasound technology to accurately locate a large joint, usually the knee or shoulder. A needle is then inserted to either extract fluid (aspiration) or inject medication. The ultrasound helps ensure precision and safety.
122 services72 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.
86 services64 patients
Destruction of peripheral nerve or branch 64640
Destruction of a peripheral nerve or branch is a procedure to treat nerve-related pain. It involves using heat, cold, or chemicals to damage or destroy the nerve, thereby blocking pain signals to the brain. This can provide long-term pain relief.
85 services17 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.
58 services58 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
38 services28 patients

Hospital Affiliations CMS Care Compare

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

Reading Hospital

Acute Care Hospitals · West Reading, PA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390044
Location420 S 5th AvenueWest Reading, PA 19611 · Berks County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 19611 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
$84.88 typical visit price
range $54.64 – $166.87
Typical copayment $21.22 (range $13.66 – $41.71)
Most-billed visit code 99203
Established Patient
$68.36 typical visit price
range $17.33 – $135.84
Typical copayment $17.09 (range $4.33 – $33.96)
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.

71.04/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Individually scored
Quality85.66
Promoting Interoperability100
Improvement Activities40
Cost17.81

Reported Quality Measures

Appropriate Use of DXA Scans in Women Under 65 Years Who Do Not Meet the Risk Factor Profile for Osteoporotic Fracture
Lower rates are better for this measure.
0%20 patients
Breast Cancer Screening
83%130 patients4/55-star benchmark: 93%
Cervical Cancer Screening
47%66 patients2/55-star benchmark: 98%
Closing the Referral Loop: Receipt of Specialist Report
8%192 patients1/55-star benchmark: 87%
Colorectal Cancer Screening
55%217 patients3/55-star benchmark: 88%
Controlling High Blood Pressure
68%162 patients4/55-star benchmark: 91%
Diabetes: Eye Exam
43%44 patients2/55-star benchmark: 100%
Diabetes: Hemoglobin A1c (HbA1c) Poor Control (>9%)
Lower rates are better for this measure.
27%44 patients4/55-star benchmark: 91%
Documentation of Current Medications in the Medical Record
97%822 patients4/55-star benchmark: 100%
e-Prescribing
100%20 patients5/55-star benchmark: 100%
Falls: Screening for Future Fall Risk
70%244 patients3/55-star benchmark: 100%
HIV Screening
20%133 patients2/55-star benchmark: 60%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
43%363 patients2/55-star benchmark: 98%
Preventive Care and Screening: Screening for Depression and Follow-Up Plan
52%258 patients3/55-star benchmark: 97%
Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented
0%371 patients1/55-star benchmark: 61%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Patients screened: 99% · 212 patients
97%212 patients
Provide Patients Electronic Access to Their Health Information
98%375 patients4/55-star benchmark: 100%
Statin Therapy for the Prevention and Treatment of Cardiovascular Disease
88%137 patients4/55-star benchmark: 91%
Use of High-Risk Medications in Older Adults
Lower rates are better for this measure.
Patients appropriateDiagnosis: 12% · 249 patients
Patients totalRate: 16% · 249 patients
16%249 patients3/55-star benchmark: 100%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

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.

ANKUSH LAHOTI M.D.
Internal Medicine (Interventional Cardiology)
301 S 7TH AVE, SUITE 2020
WEST READING, PA 19611
Berks County (610) 375-6565
RANDALL S. WINN M.D.
Specialist
301 S 7TH AVE, STE 135
WEST READING, PA 19611
Berks County (610) 988-8929
MR. TIMOTHY W MYERS PT
Physical Therapist
301 S 7TH AVE, STE 3220
WEST READING, PA 19611
Berks County (610) 376-8671
BILAL SAULAT M.D.,
Psychiatry & Neurology (Neurology)
301 S 7TH AVE, SUITE 210
READING, PA 19611
Berks County (484) 628-4656
GAIL A. LUECKE M.D.
Specialist
301 S 7TH AVE, STE 135
WEST READING, PA 19611
Berks County (610) 988-8108
DR. JOHN D CASEY MD
Orthopaedic Surgery
301 S 7TH AVE, SUITE 3220
WEST READING, PA 19611
Berks County (610) 376-8671
LEONARD J MARCHINSKI MD PC-PHYSICAL THERAPY
Physical Therapist
301 S 7TH AVE, SUITE 3020
WEST READING, PA 19611
Berks County (610) 375-6147
EARL J HOPE M.D.
Internal Medicine (Interventional Cardiology)
301 S 7TH AVE, SUITE 2020
WEST READING, PA 19611
Berks County (610) 375-6565

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 Denise Donahue's NPI number?

The NPI number for Denise Donahue is 1518091867. It was assigned to this individual provider in the NPPES registry on March 16, 2007.

Where is Denise Donahue located?

Denise Donahue practices at 301 S 7th Ave Suite 3220, West Reading, PA 19611. The listed phone number is (610) 376-8671.

What is Denise Donahue's specialty?

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

Is Denise Donahue enrolled in Medicare?

Yes. Denise Donahue 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.

Is Denise Donahue affiliated with any hospitals?

According to CMS data, Denise Donahue is affiliated with Reading Hospital.

When was this NPI record last updated?

The NPPES record for Denise Donahue was last updated on September 11, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.