DR. MARK W. DONNELLY (M.D.) – Emergency Medicine Physician, NPI 1700820784

DR. MARK W. DONNELLY (M.D.) is a healthcare provider. based in Lebanon, Oregon. specializing in EMERGENCY MEDICINE. They hold the professional credentials M.D.. They hold a License No. MD23406 (OR). The NPI Number for DR. MARK W. DONNELLY (M.D.) is 1700820784

Main info

Male
27 Years Of Experience
Accepts Medicare Assignment
Name
DR. MARK W. DONNELLY (M.D.)
NPI
1700820784
Phone
(541) 451-7115
Address
525 N SANTIAM HWY
Enumeration Date
16 June 2006
Last Update Date
8 December 2011

Doctor Profile

Medical School Name
OREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
5037692175
Graduation Year
1999 (27 years ago)
PAC ID
1658359450
Group Practice PAC ID
6103729751
Professional Enrollment ID
I20040708001305
Address ID
OR973831311ST1401XAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

824 EMERGENCY MEDICINE in OR

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Provider Addresses for DR. MARK W. DONNELLY (M.D.)

  • Santiam Highway, Lebanon, Linn County, Oregon, 97355, United States

    LEBANON, OR 973554363

    Phone: (541) 451-7115

    Fax: (541) 451-7095

    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: 2004-07-08

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
I20040708001305IEmergency MedicineORTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99284Emergency department visit with moderate level of medical decision making5655$0
99283Emergency department visit with low level of medical decision making5352$0
99282Emergency department visit with straightforward medical decision making2020$0
99285Emergency department visit with high level of medical decision making1111$0
View full utilization report →

Insurance plans in this area (ZIP 97355)

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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: 6103729751View full group profile
NameSpecialtyState
Physician AssistantOR
Cardiovascular Disease (Cardiology)CA
-OR
Nurse PractitionerOR
Physician AssistantOR
O B S T E T R I C S/ G Y N E C O L O G YOR
Family PracticeOR
P O D I A T R YOR
General SurgeryOR
Family PracticeOR

Reviews

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Frequently asked questions

Can I verify DR. MARK W. DONNELLY (M.D.) with an NPI only?
You can start verification with NPI 1700820784 for DR. MARK W. DONNELLY (M.D.), then check state licensing separately.
Does the file indicate DR. MARK W. DONNELLY (M.D.) is practicing under active NPI?
Directory data currently reports DR. MARK W. DONNELLY (M.D.) as active.
What is DR. MARK W. DONNELLY (M.D.) best known for clinically?
Directory data describes DR. MARK W. DONNELLY (M.D.) with Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
What address line appears for DR. MARK W. DONNELLY (M.D.)?
DR. MARK W. DONNELLY (M.D.)'s geographic hint is Lebanon, Oregon in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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