DR. THOMAS J MCDONALD JR. MD
NPI 1609848696
Internal Medicine - Gastroenterology in Sayre, PA

Active since February 03, 2006PECOS EnrolledAccepts Medicare Assignment
82.9/100
CMS Quality Rating

NPPES record last updated: March 29, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Thomas J Mcdonald Jr. Md NPPES

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

DR. THOMAS J MCDONALD JR. MD (NPI 1609848696) is an individual gastroenterology provider in Sayre, Pennsylvania, licensed in Pennsylvania (MD032268E) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS, is affiliated with Our Lady Of Lourdes Memorial Hospital, Inc, and is a graduate of Hahnemann University College Of Medicine (1983).

NPPES Registry Identity

NPI1609848696
Entity TypeIndividualMale
Primary Taxonomy207RG0100X
Provider Legal NameDR. THOMAS J MCDONALD JR.Credential: MD
Location Address1 GUTHRIE SQSayre, PA 18840-1625
Mailing Address1 Guthrie SqSayre, PA 18840-1625 · (570) 888-5858
Sole ProprietorNo
Medical School CMSHahnemann University College Of MedicineGraduated 1983
Enumeration DateFebruary 3, 2006
Last NPPES UpdateMarch 29, 2021
NPPES CertifiedMarch 29, 2021
NPI 1609848696 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
Licenses Licensed in PA · MD032268E Licensed in NY · 179149-1
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
1 GUTHRIE SQ, Sayre, PA 18840

Other Identifiers 7

Other100014271PA · Rr Medicare Pin
OtherP00315704NY · Rr Medicare Pin
Medicaid0010401180002PA
OtherCC8362NY · Rr Medicare Group
OtherCC9269PA · Rr Medicare Group
OtherGU616091PA · Pa Medicare Group
Medicaid01131704NY

Accepted 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

Dr. Thomas J Mcdonald Jr. 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 ID7911022074
PECOS Enrollment IDI20100913000601, I20101029000004
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 20

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.

Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports, requiring the presence of an independent trained observer to assist in the monito G0500
Moderate sedation is a method where a physician uses medication to help you relax during a gastrointestinal endoscopy. An independent trained observer will be present to monitor your vital signs and ensure your safety throughout the procedure. It's a common and safe practice.
163 services161 patients
Removal of polyps or growths of large bowel using an endoscope with mechanical snare 45385
This procedure involves using a thin, flexible tube called an endoscope to examine the large bowel. If any abnormal growths or polyps are found, a tool called a mechanical snare is used to remove them. This is a common method to prevent potential health issues.
137 services136 patients
Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43239
This procedure involves using a thin, flexible tube with a light and camera, known as an endoscope, to examine the esophagus, stomach, and upper part of the small intestine. Small tissue samples are taken for further examination to help diagnose various conditions.
121 services116 patients
Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes 99232
Follow-up hospital inpatient care involves daily check-ups while you're admitted in the hospital. Typically, a healthcare provider spends about 25 minutes each day reviewing your condition, adjusting treatment if needed, and answering any questions you might have.
103 services57 patients
Colorectal cancer screening; colonoscopy on individual at high risk G0105
Colorectal cancer screening, specifically a colonoscopy, is a preventive measure for those at high risk. A thin, flexible tube with a camera inspects the colon to spot any abnormal growths. This test helps detect potential issues early, enhancing the effectiveness of treatment.
83 services82 patients
Diagnostic exam of esophagus, stomach, and/or upper small bowel using a flexible endoscope 43235
This procedure, known as an upper endoscopy, involves inserting a thin, flexible tube with a camera down the throat to examine the esophagus, stomach, and upper small bowel. It helps diagnose conditions like ulcers or inflammation.
55 services54 patients

Hospital Affiliations CMS Care Compare 4

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

Our Lady Of Lourdes Memorial Hospital, Inc

Acute Care Hospitals · Binghamton, NY
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330011
Location169 Riverside DriveBinghamton, NY 13905 · Broome County
Emergency services Birthing friendly

Guthrie Cortland Regional Medical Center

Acute Care Hospitals · Cortland, NY
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330175
Location134 Homer AvenueCortland, NY 13045 · Cortland County
Emergency services Birthing friendly

Corning Hospital

Acute Care Hospitals · Corning, NY
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330277
Location1 Guthrie DriveCorning, NY 14830 · Steuben County
Emergency services Birthing friendly

Robert Packer Hospital

Acute Care Hospitals · Sayre, PA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number390079
LocationOne Guthrie SquareSayre, PA 18840 · Bradford County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 18840 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
$126.34 typical visit price
range $54.64 – $166.87
Typical copayment $31.58 (range $13.66 – $41.71)
Most-billed visit code 99204
Established Patient
$96.82 typical visit price
range $17.33 – $135.84
Typical copayment $24.20 (range $4.33 – $33.96)
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.

82.9/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality74.09
Promoting Interoperability100
Improvement Activities40
Cost65.94

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.

Psychologist
1 GUTHRIE SQ
SAYRE, PA 18840
Emergency Medicine
1 GUTHRIE SQ
SAYRE, PA 18840
Occupational Therapist
1 GUTHRIE SQ
SAYRE, PA 18840
Internal Medicine
1 GUTHRIE SQ
SAYRE, PA 18840
Student in an Organized Health Care Education/Training Program
1 GUTHRIE SQ
SAYRE, PA 18840
Radiology (Diagnostic Radiology)
1 GUTHRIE SQ
SAYRE, PA 18840
Hospitalist
1 GUTHRIE SQ
SAYRE, PA 18840
Physician Assistant
1 GUTHRIE SQ
SAYRE, PA 18840

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 1609848696. It was assigned to this individual provider in the NPPES registry on February 3, 2006.

Where is Thomas Mcdonald located?

Thomas Mcdonald practices at 1 Guthrie Sq, Sayre, PA 18840. The listed phone number is (570) 888-5858.

What is Thomas Mcdonald's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

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.

What insurance does Thomas Mcdonald accept?

Health plans from Ambetter Health, Ambetter Health of Delaware and Ambetter from Buckeye Health Plan 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 Our Lady Of Lourdes Memorial Hospital, Inc, Guthrie Cortland Regional Medical Center, Corning Hospital and Robert Packer Hospital.

When was this NPI record last updated?

The NPPES record for Thomas Mcdonald was last updated on March 29, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.