Physician Compare National (NPI:1073623153)

HEALTHCARE PROVIDER: DENNIS JOSEPH MCDONAGH MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1073623153
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6800884446
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20040503001736
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MCDONAGH
	Individual professional last name
Provider First Name	DENNIS
	Individual professional first name
Provider Middle Name	J
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.
Provider Credential Text	MD
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	ST. LOUIS COLLEGE OF PHYSICIANS AND SURGEONS
	Individual professional's medical school
Graduation Year	1969
	Individual professional's medical school graduation year
Primary Specialty	INTERNAL MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment
Secondary Specialty 1	PULMONARY DISEASE
	First secondary medical specialty reported by the individual professional in the selected enrollment
All Secondary Specialties	PULMONARY DISEASE
	All four secondary specialties reported by the individual professional in the selected enrollment, separated by commas

Practice Information
Line 1 Street Address	2636 FOREST CIR
	Group Practice or individual's line 1 address
City	JACKSONVILLE
	Group Practice or individual's city
State	FL
	Group Practice or individual's state
Zip Code	322575612
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y