MICHELLE MCDONALD – Developmental Therapist, NPI 1790965002

MICHELLE MCDONALD is a healthcare provider. based in Jacksonville, Florida. specializing in QUALIFIED SPEECH LANGUAGE PATHOLOGIST. The NPI Number for MICHELLE MCDONALD is 1790965002

Main info

Female
Sole Proprietor
8 Years Of Experience
Accepts Medicare Assignment
Name
MICHELLE MCDONALD
NPI
1790965002
Phone
(336) 601-3905
Address
3839 ROBENA RD
Enumeration Date
5 November 2007
Last Update Date
26 July 2013

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2396762080
Graduation Year
2018 (8 years ago)
PAC ID
9830590728
Group Practice PAC ID
5395078968
Professional Enrollment ID
I20210707003897
Address ID
FL341137369NA8417XBLVD400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:18State licenses:0Digital endpointsOther names

570 QUALIFIED SPEECH LANGUAGE PATHOLOGIST in FL

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Provider Addresses for MICHELLE MCDONALD

  • 3839, Robena Road, Jacksonville, Duval County, Florida, 32218, United States

    JACKSONVILLE, FL 322187582

    Phone: (336) 601-3905

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-07-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210707003897IQualified Speech Language PathologistFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32218)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5395078968View full group profile
NameSpecialtyState
Occupational Therapist In Private PracticeNJ
Physical Therapist In Private PracticeFL
Physical Therapist In Private PracticeFL
Physical Therapist In Private PracticeFL
Occupational Therapist In Private PracticeMI
-FL
Physical Therapist In Private PracticeUT
Physical Therapist In Private PracticeNJ
Physical Therapist In Private PracticeFL
Physical Therapist In Private PracticeFL

Reviews

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Frequently asked questions

What number should I use to identify MICHELLE MCDONALD for billing?
Administrative and clinical systems typically use NPI 1790965002 for MICHELLE MCDONALD.
Is MICHELLE MCDONALD currently accepting referrals based on NPI status?
Registry metadata lists MICHELLE MCDONALD as active.
What does the directory say MICHELLE MCDONALD does?
Insurance directories may phrase it differently, but here MICHELLE MCDONALD maps to Developmental Therapist. Clinical services aligned with this taxonomy classification.
Which community is linked to MICHELLE MCDONALD?
MICHELLE MCDONALD shows a connection to Jacksonville, Florida in registry-derived data.
Why is information missing for MICHELLE MCDONALD?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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