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MATTHEW DENNIS MCDONALD D.O
NPI 1619167640
Surgery in Troy, NY

Active since July 26, 2007PECOS EnrolledAccepts Medicare Assignment
720 HOOSICK ROAD, BARIATRIC AND METABOLIC CARE, TROY, NY 12180(518) 687-9779 Get Directions Write a Review

NPPES record last updated: May 21, 2021. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: May 21, 2021, Apr 26, 2019 (2 updates tracked since 2019).

About Matthew Dennis Mcdonald D.o NPPES

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

MATTHEW DENNIS MCDONALD D.O (NPI 1619167640) is an individual surgery provider in Troy, New York, licensed in New York (2383581) and active in the NPI registry since July 2007. He is enrolled in Medicare PECOS, is affiliated with Samaritan Hospital Of Troy, New York, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1619167640
Entity TypeIndividualMale
Primary Taxonomy208600000X
Provider Legal NameMATTHEW DENNIS MCDONALDCredential: D.O
Location Address720 HOOSICK ROAD, BARIATRIC AND METABOLIC CARETroy, NY 12180
Mailing AddressPo Box 14890Albany, NY 12212-4890
Phone(518) 687-9779
Sole ProprietorNo
Medical School CMSNew York College Of Osteo Medicine Of New York Institute Of TechnologyGraduated 2001
Enumeration DateJuly 26, 2007
Last NPPES UpdateMay 21, 20212 updates tracked since enumeration
NPPES CertifiedMay 21, 2021
✔ NPI 1619167640 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySurgeryAllopathic & Osteopathic Physicians
Taxonomy Code208600000X
License✔ Licensed in NY · 2383581
Definition
A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.
720 HOOSICK ROAD, Troy, NY 12180
Open in Google Maps ↗

Secondary Practice Locations 2

Location 1750 E Adams StSyracuse, NY 13210-2342 · Phone (315) 464-1800 · Fax (315) 464-0247
Location 2319 So Manning Blvd Suite 307, St. Peter's Bariatric CareAlbany, NY 12208 · Phone (518) 525-5208

Other Identifiers 1

Medicaid03175660NY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Harvard Pilgrim Health Care.Insurance ›

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

Matthew Dennis Mcdonald D.o 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 ID7315139045
PECOS Enrollment IDI20101013000104, I20220216002294
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

6

Medicare enrollment records show Matthew Mcdonald reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

St Peters Health Partners Medical Associates, P.C.
1.6 mi
Urology
2231 BURDETT AVENUE SUITE 230
Troy, NY 12180
  • Reassigned Medicare billing, New York enrollment
  • Medicare enrollment name: St. Peter's Health Partners Medical Associates, P.C.
  • 742 clinicians in this Medicare group
NPI 1336575430 (518) 272-1333
Capital Cardiology Associates PLLC
7.5 mi
Cardiovascular Disease
7 SOUTHWOODS BLVD
Albany, NY 12211
  • Reassigned Medicare billing, Vermont enrollment
NPI 1518952332 (518) 292-6000
Twin Rivers Medical PC
7.5 mi
Surgery
7 SOUTHWOODS BLVD
Albany, NY 12211
  • Reassigned Medicare billing, New York and Vermont enrollments
  • 20 clinicians in this Medicare group
NPI 1063229458 (518) 641-6580
Southwestern Vermont Medical Center Inc.
24 mi
Oncology
140 HOSPITAL DR, SUITE 116
Bennington, VT 05201
  • Reassigned Medicare billing, Vermont enrollment
  • Also billed through NPI 1740682921 (Vermont)
  • 143 clinicians in this Medicare group
NPI 1962650556 (802) 447-1836
Health Quest Medical Practice, PC
56 mi
Diagnostic Radiology
1240 ULSTER AVENUE
Kingston, NY 12401
  • Reassigned Medicare billing, New York enrollment
  • Medicare enrollment name: Nuvance Health Medical Practice PC
  • 638 clinicians in this Medicare group
NPI 1558906610 (845) 443-8720
University Surgical Associates, LLP
128 mi
Surgery
750 E ADAMS ST, STE. 8140
Syracuse, NY 13210
  • Reassigned Medicare billing, New York enrollment
  • 115 clinicians in this Medicare group
NPI 1376590117 (315) 464-1800

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 9

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 high level of medical decision making, if using time, 40 minutes or more 99215
This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.
91 services45 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
26 services18 patients
Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count 85025
A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.
22 services17 patients
Blood test, comprehensive group of blood chemicals 80053
A comprehensive group of blood chemicals test, also known as a comprehensive metabolic panel, is a blood test that measures your sugar level, electrolyte and fluid balance, kidney function, and liver function. This helps to check your body's overall health.
17 services14 patients
Magnesium level 83735
A magnesium level test is a simple blood test that measures the amount of magnesium in your body. Magnesium is a crucial mineral that helps your nerves, muscles, and heart function properly. The test can help detect health conditions like kidney disease or malnutrition.
15 services13 patients
Blood test, thyroid stimulating hormone (tsh) 84443
A TSH blood test measures the level of thyroid stimulating hormone in your body. This hormone is produced by the pituitary gland and regulates how your thyroid works. It's a simple procedure where a small amount of blood is drawn from your arm for analysis.
14 services13 patients

Hospital Affiliations CMS Care Compare 2

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

Samaritan Hospital Of Troy, New York

Acute Care Hospitals · Troy, NY
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number330180
Location2215 Burdett AvenueTroy, NY 12180 · Rensselaer County
Emergency services Birthing friendly

Southwestern Vermont Medical Center

Acute Care Hospitals · Bennington, VT
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number470012
Location100 Hospital DriveBennington, VT 05201 · Bennington County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 12180 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
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.57 typical visit price
range $17.54 – $136.14
Typical copayment $17.14 (range $4.38 – $34.03)
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.

Reported Quality Measures

Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
67%212 patients4/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
36%148 patients2/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
98%482 patients4/55-star benchmark: 99%
Health Information Exchange
The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…
49%524 patients3/55-star benchmark: 88%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
100%302 patients5/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
98%564 patients5/55-star benchmark: 97%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
100%525 patients5/55-star benchmark: 97%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
75%563 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
27%563 patients2/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
54%563 patients
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 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ST. PETER'S HEALTH PARTNERS MEDICAL ASSOCIATES, P.C.
Family Medicine
720 HOOSICK ROAD, TROY MEDICAL GROUP
TROY, NY 12180
Rensselaer County (518) 272-7191
LORI HOUGHTALING RD CDN
Dietitian, Registered
720 HOOSICK ROAD, BARIATRIC AND METABOLIC CARE
TROY, NY 12180
Rensselaer County (518) 687-9781

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 Matthew Mcdonald's NPI number?

The NPI number for Matthew Mcdonald is 1619167640. It was assigned to this individual provider in the NPPES registry on July 26, 2007.

Where is Matthew Mcdonald located?

Matthew Mcdonald practices at 720 Hoosick Road Bariatric And Metabolic Care, Troy, NY 12180. The listed phone number is (518) 687-9779.

What is Matthew Mcdonald's specialty?

The primary specialty registered for this NPI is Surgery with taxonomy code 208600000X.

Is Matthew Mcdonald enrolled in Medicare?

Yes. Matthew 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 Matthew Mcdonald's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Matthew Mcdonald reassigns Medicare benefits to 6 organizations: St Peters Health Partners Medical Associates, P.C. (Troy, NY), Capital Cardiology Associates PLLC (Albany, NY), Twin Rivers Medical PC (Albany, NY), Southwestern Vermont Medical Center Inc. (Bennington, VT), Health Quest Medical Practice, PC (Kingston, NY) and 1 more organization, listed in the Medicare section above. 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 Matthew Mcdonald's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Matthew Mcdonald accept?

Health plans from Anthem Blue Cross and Blue Shield and Harvard Pilgrim Health Care list Matthew 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 Matthew Mcdonald affiliated with any hospitals?

According to CMS data, Matthew Mcdonald is affiliated with Samaritan Hospital Of Troy, New York and Southwestern Vermont Medical Center.

When was this NPI record last updated?

The NPPES record for Matthew Mcdonald was last updated on May 21, 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.