RICHARD E DONNELLY P.A.-C.
NPI 1396729455
Physician Assistant - Surgical in Lakeside, AZ
NPI Status: Active since December 02, 2005
Contact Information
43 W. WHITE MOUNTAIN BLVD
LAKESIDE, AZ
ZIP 85929
Phone: (928) 367-4040
Fax: (928) 367-4042
- Individual
- Male
- Physician Assistant
- Surgical
About RICHARD DONNELLY
This page provides the complete NPI Profile along with additional information for Richard Donnelly, a provider established in Lakeside, Arizona with a medical specialization in Physician Assistant, focusing in surgical . The healthcare provider is registered in the NPI registry with number 1396729455 assigned on December 2005. The practitioner's primary taxonomy code is 363AS0400X with license number 1105 (AZ). The provider is registered as an individual and his NPI record was last updated 15 years ago.
- NPI
- 1396729455
- Provider Name
- RICHARD E DONNELLY P.A.-C.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 43 W. WHITE MOUNTAIN BLVD LAKESIDE, AZ 85929
- Location Phone
- (928) 367-4040
- Location Fax
- (928) 367-4042
- Mailing Address
- 43 W WHITE MOUNTAIN BLVD LAKESIDE, AZ 85929
- Mailing Phone
- (928) 367-4040
- Mailing Fax
- (928) 367-4042
- Is Sole Proprietor?
- Yes
- Enumeration Date
- 12-02-2005
- Last Update Date
- 02-16-2011
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physician Assistant Surgical
- Taxonomy Code
- 363AS0400X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- 1105
- License State
- AZ
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 363AS0400X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 10186 (MN) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 86080015085259A253 | OTHER (01) | AZ | TRIWEST |
| 970001299 | OTHER (01) | AZ | RAILROAD MEDICARE |
| R10773 | MEDICARE UPIN (02) | ||
| PA1105 | MEDICARE ID-TYPE UNSPECIFIED (04) | AZ | |
| P00338849 | MEDICARE ID-TYPE UNSPECIFIED (04) | MN | RAILROAD |
| 970002638 | MEDICARE ID-TYPE UNSPECIFIED (04) | MN | |
| 558930400 | MEDICAID (05) | MN | |
| 342254 | MEDICAID (05) | AZ |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 3 | 9 | 6 | 7 | 2 | 9 | 4 | 5 | 5 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 3 | 18 | 6 | 14 | 2 | 18 | 4 | 10 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 3 + 1 + 8 + 6 + 1 + 4 + 2 + 1 + 8 + 4 + 1 + 0 + 24 = 65 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 65 = 5 | 5 | ||||||||
The NPI number 1396729455 is valid because the calculated check digit 5 using the Luhn validation algorithm matches the last digit of the original NPI number.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1396729455, enumerated in the NPI registry as an "individual" on December 02, 2005
The provider is located at 43 W. White Mountain Blvd Lakeside, Az 85929 and the phone number is (928) 367-4040
The provider's speciality is Physician Assistant with taxonomy code 363AS0400X with a focus in Surgical
The provider might be accepting Accepts: Medicare, Medicaid and Railroad Medicare. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
This NPI record was last updated on December 02, 2005. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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