PHILIP E DONAHUE FNP
NPI 1770691214
Emergency Medicine in Great Falls, MT
Quality Rating: 87.09 out of 100 score
NPI Status: Active since August 25, 2006
Contact Information
1101 26TH ST S
GREAT FALLS, MT
ZIP 59405
Phone: (406) 622-5955
- Individual
- Male
- Emergency Medicine
- PECOS Enrolled
- Medicare Quality Reporting
About PHILIP DONAHUE
This page provides the complete NPI Profile along with additional information for Philip Donahue, a provider established in Great Falls, Montana with a medical specialization in Emergency Medicine. The healthcare provider is registered in the NPI registry with number 1770691214 assigned on August 2006. The practitioner's primary taxonomy code is 207P00000X with license number RN12678 (MT). The provider is registered as an individual and his NPI record was last updated 18 years ago.
- NPI
- 1770691214
- Provider Name
- PHILIP E DONAHUE FNP
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1101 26TH ST S GREAT FALLS, MT 59405
- Location Phone
- (406) 622-5955
- Mailing Address
- PO BOX 1474 FORT BENTON, MT 59442
- Mailing Phone
- (406) 622-5955
- Is Sole Proprietor?
- No
- Enumeration Date
- 08-25-2006
- Last Update Date
- 07-08-2007
- 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
Emergency Medicine
- Taxonomy Code
- 207P00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- RN12678
- License State
- MT
- Taxonomy Description
- An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.
Medicare Participation & PECOS Enrollment Status
Philip Donahue is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Durable Medical Equipment (DME) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: No
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Emergency department visit for life threatening or functioning severity
Emergency department visit for problem of high severity
Emergency department visit for problem of moderate severity
Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only
An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.
This service was performed 16 times for 16 patientsAn emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.
This service was performed 46 times for 45 patientsAn emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.
This service was performed 33 times for 33 patientsA routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.
This service was performed 31 times for 30 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 59405 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99203
- Average New Patient Price $87.97
- Minimum New Patient Price $56.81
- Maximum New Patient Price $172.26
- Average New Patient Copayment $21.99
- Minimum New Patient Copayment $14.2
- Maximum New Patient Copayment $43.06
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $100.16
- Minimum Established Patient Price $18.24
- Maximum Established Patient Price $140.32
- Average Established Patient Copayment $25.04
- Minimum Established Patient Copayment $4.56
- Maximum Established Patient Copayment $35.08
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Overall MIPS Quality Performance
The provider participated in CMS Quality Payment Program under the Merit-based Incentive Payment System (MIPS) and has an overall final score of 87.09, based on four performance areas: quality, improvement activities, promoting interoperability, and cost. The purpose of this information is to help people with Medicare make informed decisions and incentivize doctors and clinicians to maximize performance.
The Merit-based Incentive Payment System (MIPS) is a way providers could use to participate in CMS Quality Payment Program (QPP). The MIPS program affects clinician reimbursement for Part B covered professional services and also rewards them for improving the quality of patient care and outcomes.
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Final Score: 87.09 out of 100
The MIPS program evaluates providers across multiple categories with a specific weight for each category resulting a in a MIPS final score that ranges from 0 to 100 points. The MIPS Final Score determines whether providers receive a negative, neutral or positive MIPS payment adjustment.
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Quality Score: 79.44
The Quality category assesses providers performance on clinical practices and patient outcomes under the traditional MIPS program. The quality measures help identify the quality of healthcare processes, outcomes, and patient experiences. The Quality measure category compromises 40% providers final MPIS scores.
There are six collection types for MIPS quality measures: Electronic Clinical Quality Measures (eCQMs), MIPS Clinical Quality Measures (CQMs), Qualified Clinical Data Registry (QCDR) Measures, Medicare Part B claims measures, CMS Web Interface measures and The Consumer Assessment of Healthcare Providers and Systems (CAHPS) for MIPS Survey.
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Promoting Interoperability Score: 91.23
The Interoperability category measures the providers ability to use technology to exchange and make use of healthcare information in a way that is less burdensome and improves outcomes. The Interoperability measure category compromises 25% providers final MPIS scores.
The MIPS Interoperability measure focuses on the use of certified electronic health record technology (CEHRT) to improve patient access health information, the exchange of information between clinicians and pharmacies and the systematic collection, analysis, and interpretation of healthcare data. -
Improvement Activities Score: 40
The Improvement Activities performance category evaluates the providers participation in clinical activities that support the improvement of clinical practice, care delivery, and outcomes. Providers have the option to choose 2 to 4 activities from an inventory of over 100 improvement activities. Providers typically choose the activities that best fit their needs. The improvement activities measure category compromises 15% providers final MPIS scores.
The Improvement measures aim to better patient engagement, patient safety and other areas of patient care. The Improvement Activities category compromises 15% of providers final MPIS scores. -
Cost Score: N/A
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores. -
Cost Score: N/A
The Cost performance category asses the amount and types of services provided and how clinicians coordinate care and seek improvement of health outcomes by ensuring patients receive the appropriate services.
Although providers don't determine the price of healthcare services they are important in delivering high-quality care at a reasonable cost. The Cost measures category compromises 20% of providers final MPIS scores.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Breast Cancer Screening | 60% | 297 |
| Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer | ||
| Chronic Care and Preventative Care Management for Empaneled Patients | Yes | N/A |
| Proactively manage chronic and preventive care for empaneled patients that could include one or more of the following: • Provide patients annually with an opportunity for development and/or adjustment of an individualized plan of care as appropriate to age and health status, including health risk appraisal; gender, age and condition-specific preventive care services; and plan of care for chronic conditions; • Use condition-specific pathways for care of chronic conditions (e.g., hypertension, diabetes, depression, asthma and heart failure) with evidence-based protocols to guide treatment to target; such as a CDC-recognized diabetes prevention program; • Use pre-visit planning to optimize preventive care and team management of patients with chronic conditions; • Use panel support tools (registry functionality) to identify services due; • Use predictive analytical models to predict risk, onset and progression of chronic diseases; or • Use reminders and outreach (e.g., phone calls, emails, postcards, patient portals and community health workers where available) to alert and educate patients about services due; and/or routine medication reconciliation. | ||
| Colorectal Cancer Screening | 44% | 551 |
| Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer | ||
| Documentation of Current Medications in the Medical Record | 99% | 1517 |
| Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter. This list must include ALL known prescriptions, over-the-counters, herbals, and vitamin/mineral/dietary (nutritional) supplements AND must contain the medications' name, dosage, frequency and route of administration | ||
| e-Prescribing | 99% | 1082 |
| At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology. | ||
| Immunization Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement with a public health agency to submit immunization data. | ||
| Implementation of medication management practice improvements | Yes | N/A |
| Manage medications to maximize efficiency, effectiveness and safety that could include one or more of the following: Reconcile and coordinate medications and provide medication management across transitions of care settings and eligible clinicians or groups; Integrate a pharmacist into the care team; and/or Conduct periodic, structured medication reviews. | ||
| Measurement and Improvement at the Practice and Panel Level | Yes | N/A |
| Measure and improve quality at the practice and panel level, such as the American Board of Orthopaedic Surgery (ABOS) Physician Scorecards, that could include one or more of the following: • Regularly review measures of quality, utilization, patient satisfaction and other measures that may be useful at the practice level and at the level of the care team or MIPS eligible clinician or group (panel); and/or • Use relevant data sources to create benchmarks and goals for performance at the practice level and panel level. | ||
| Patient-Specific Education | 36% | 1828 |
| 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. | ||
| Pneumococcal Vaccination Status for Older Adults | 60% | 440 |
| Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine | ||
| Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention | 89% | 110 |
| Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user | ||
| Provide Patient Access | 96% | 1828 |
| 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 certain information. | ||
| Secure Messaging | 11% | 1828 |
| 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 message sent by the patient (or the patient-authorized representative) during the performance period. | ||
| Security Risk Analysis | Yes | N/A |
| Conduct or review a security risk analysis in accordance with the requirements in 45 CFR 164.308(a)(1), including addressing the security (to include encryption) of ePHI data created or maintained by certified EHR technology in accordance with requirements in 45 CFR164.312(a)(2)(iv) and 45 CFR 164.306(d)(3), and implement security updates as necessary and correct identified security deficiencies as part of the MIPS eligible clinician's risk management process. | ||
| Specialized Registry Reporting | Yes | N/A |
| The MIPS eligible clinician is in active engagement to submit data to specialized registry. To earn a 5 % bonus in the promoting interoperability performance category score for submitting to one or more public health or clinical data registries also attest to PI_TRANS_PHCDRR_3_MULTI. | ||
| Use of decision support and standardized treatment protocols | Yes | N/A |
| Use decision support and standardized treatment protocols to manage workflow in the team to meet patient needs. | ||
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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 | 7 | 7 | 0 | 6 | 9 | 1 | 2 | 1 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 7 | 14 | 0 | 12 | 9 | 2 | 2 | 2 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 7 + 1 + 4 + 0 + 1 + 2 + 9 + 2 + 2 + 2 + 24 = 56 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 56 = 4 | 4 | ||||||||
The NPI number 1770691214 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1124029004 | CHU SHEI HONG MD Individual | Hospitalist | 1101 26TH ST S GREAT FALLS, MT 59405 (406) 455-5319 |
| 1922009802 | GARY A BUFFINGTON MD Individual | Internal Medicine | 1101 26TH ST S GREAT FALLS, MT 59405 (406) 455-4690 |
| 1962403840 | DEBBIE K BJORSNESS RD Individual | Dietitian, Registered (Nutrition, Metabolic) | 1101 26TH ST S GREAT FALLS, MT 59405 (406) 455-5526 |
| 1679523427 | DR. PHILIP ALAN RIEDEL M.D. Individual | Pediatrics (Neonatal-Perinatal Medicine) | 1101 26TH ST S GREAT FALLS, MT 59405 (406) 455-5000 |
| 1184679706 | SYNERGY MEDICAL CARE Organization | Emergency Medicine | 1101 26TH ST S GREAT FALLS, MT 59405 (406) 622-5955 |
| 1477597359 | DARRIN LEE DIXON CRNA Individual | Nurse Anesthetist, Certified Registered | 1101 26TH ST S GREAT FALLS, MT 59405 (406) 455-4470 |
| 1073548301 | ANNE MARIE BURNETT FNP Individual | Nurse Practitioner | 1101 26TH ST S GREAT FALLS, MT 59405 (406) 455-5200 |
| 1114952447 | EMERGENCY PHYSICIANS P.C. Organization | Emergency Medicine | 1101 26TH ST S GREAT FALLS, MT 59405 (406) 622-5955 |
| 1649385014 | MRS. BECKETT SAXMAN PERKINS NNP, APRN Individual | Nurse Practitioner (Neonatal) | 1101 26TH ST S GREAT FALLS, MT 59405 (406) 455-5505 |
| 1356453252 | DAVID F. SIMPSON D.O. Individual | Emergency Medicine | 1101 26TH ST S GREAT FALLS, MT 59405 (406) 455-5200 |
| 1649382581 | ROBERT TODD HARPER D.O. Individual | Emergency Medicine | 1101 26TH ST S GREAT FALLS, MT 59405 (406) 455-5200 |
| 1588776355 | ANDREW A. BARBER D.O. Individual | Emergency Medicine | 1101 26TH ST S GREAT FALLS, MT 59405 (406) 455-5200 |
| 1780778100 | JOHN C. HACKETHORN MD Individual | Radiology (Diagnostic Radiology) | 1101 26TH ST S GREAT FALLS, MT 59405 (406) 455-5665 |
| 1518053081 | GARY L. SCHUMACHER MD Individual | Radiology (Diagnostic Radiology) | 1101 26TH ST S GREAT FALLS, MT 59405 (406) 455-5665 |
| 1841344132 | DR. GERALD IRVIN GEISZLER M.D. Individual | Emergency Medicine | 1101 26TH ST S GREAT FALLS, MT 59405 (406) 761-6383 |
| 1346396843 | DR. RANDY LEE KUIPER PHARMD Individual | Pharmacist (Pharmacotherapy) | 1101 26TH ST S GREAT FALLS, MT 59405 (406) 455-5043 |
| 1801933619 | DEAN HERBERT ORVIS PT Individual | Physical Therapist | 1101 26TH ST S GREAT FALLS, MT 59405 (406) 455-5000 |
| 1558484402 | DR. PAUL GREGORY DOLAN M.D. Individual | Internal Medicine (Geriatric Medicine) | 1101 26TH ST S GREAT FALLS, MT 59405 (406) 455-5485 |
| 1205047925 | PROF. RONALD MARK WARD BS Individual | General Acute Care Hospital | 1101 26TH ST S GREAT FALLS, MT 59405 (406) 455-5412 |
| 1477764454 | BARBARA RUTH DOUGHTY M.A., CCC-SLP Individual | Speech-Language Pathologist | 1101 26TH ST S GREAT FALLS, MT 59405 (406) 455-5238 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1770691214, enumerated in the NPI registry as an "individual" on August 25, 2006
The provider is located at 1101 26th St S Great Falls, Mt 59405 and the phone number is (406) 622-5955
The provider's speciality is Emergency Medicine with taxonomy code 207P00000X
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Durable Medical Equipment (DME) and Power Mobility Devices.
The provider has an overall high rating in the following quality measures: uses technology to exchange and make use of healthcare information.
Medicare beneficiaries should expect a typical cost of $87.97 with an average copayment of $21.99 for new patient appointments. Established patients should expect a typical charge of $100.16 and an average copayment of 25.04. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Emergency department visit for life threatening or functioning severity, Emergency department visit for problem of high severity, Emergency department visit for problem of moderate severity and Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only.
This NPI record was last updated on August 25, 2006. 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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