Active NPI 1164409918 Individual Practitioner Male Practitioner

Dr. John P Donahue , MD

Ophthalmology • Providence, RI

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Dr. John Donahue, MD is a certified Ophthalmology practicing in Providence, RI. With approximately 32 years of clinical experience since graduating from University Of Colorado School Of Medicine, Denver in 1994, Dr. Donahue delivers high-quality medical care to the local community at 150 E MANNING ST.

Dr. Donahue is affiliated with Refocus Eye Health Of Ri, Llc and accepts Medicare assignment.

Frequently performed procedures and clinical services include exam to measure eye deviation and range of motion, established patient outpatient office visit, realignment of the eye with repair of one horizontal eye muscle. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

150 E Manning St

Providence, RI 029065109

Telephone 4012722020

Fax 4014215979

Associated Practice Facility / Clinic

🏢 Ophthalmology Inc Facility NPI 1366429102

Medicare Profile & Education

Medical School

University Of Colorado School Of Medicine, Denver

Graduation Year

1994

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Ophthalmology in Providence, RI

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

32 Yrs +2.1 yrs vs City Avg

City Avg: 29.9 Yrs

State Avg: 33.9 Yrs

Regional Practice Density

34 Specialists

Practicing in Providence, RI (92 Statewide)

Telehealth Adoption Rate

8.8% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

58.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Donahue (32 Years) 32 Yrs

Providence Specialty Average (29.9 Years) 29.9 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92060 Exam to measure eye deviation and range of motion	33	33	$138.19	$64.93
99213 Established patient office or other outpatient visit, typically 15 minutes	20	19	$241.28	$91.83
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	12	12	$306.66	$129.89

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92060 Exam to measure eye deviation and range of motion	54	53	$144.03	$64.12
99213 Established patient office or other outpatient visit, typically 15 minutes	36	33	$215.56	$92.54
67311 Realignment of the eye with repair of one horizontal eye muscle	14	13	$1812.89	$592.31
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	14	14	$277.64	$130.26

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92060 Exam to measure eye deviation and range of motion	63	56	$142.19	$65.68
99213 Established patient office or other outpatient visit, typically 15 minutes	39	33	$215.41	$94.34
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	15	14	$276.25	$132.56
67311 Realignment of the eye with repair of one horizontal eye muscle	13	12	$1877.63	$590.40
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	11	11	$365.78	$172.87

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92060 Exam to measure eye deviation and range of motion	73	66	$155.90	$66.82
99213 Established patient office or other outpatient visit, typically 15 minutes	44	40	$202.63	$95.58
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	19	17	$269.47	$135.50
67311 Realignment of the eye with repair of one horizontal eye muscle	16	15	$2313.39	$721.29
92014 Established patient complete exam of visual system	11	11	$314.55	$133.76

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92060 Exam to measure eye deviation and range of motion	43	41	$146.74	$67.66
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	26	25	$267.50	$114.79
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	13	13	$290.00	$175.20

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92060 Exam to measure eye deviation and range of motion	65	61	$152.08	$67.96
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	31	30	$275.32	$113.14
99213 Established patient office or other outpatient visit, typically 15 minutes	19	19	$195.42	$77.87
92014 Established patient complete exam of visual system	15	15	$311.60	$133.31
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	15	15	$330.00	$172.85

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92060 Exam to measure eye deviation and range of motion	62	53	$112.76	$68.21
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	38	31	$174.00	$111.89
92012 Established patient problem focused exam of visual system	19	14	$231.68	$92.23
99213 Established patient office or other outpatient visit, typically 15 minutes	13	12	$153.15	$76.14
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	13	13	$287.38	$171.79
67311 Realignment of the eye with repair of one horizontal eye muscle	13	13	$1625.31	$700.83
92014 Established patient complete exam of visual system	12	12	$264.67	$132.60

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
92060 Exam to measure eye deviation and range of motion	104	88	$116.38	$67.50
92012 Established patient problem focused exam of visual system	53	46	$219.36	$88.70
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	38	36	$180.00	$104.21
92014 Established patient complete exam of visual system	27	27	$260.74	$124.06
92004 New patient complete exam of visual system	16	16	$266.50	$154.79
67311 Realignment of the eye with repair of one horizontal eye muscle	13	13	$1605.23	$685.84
92002 New patient problem focused exam of visual system	12	12	$209.00	$84.06
67314 Realignment of the eye with repair of one vertical muscle	12	12	$1304.00	$664.88

Medical Specialties & State Licenses

Ophthalmology Primary Specialty

NUCC Taxonomy Code: 207W00000X

State License RI MD10345

An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

9001520 (RI)

Medicaid State Provider ID

7008251 (RI)

Commercial Insurance / Payer ID Nhp Ri Group #

0859 (RI)

Commercial Insurance / Payer ID Tufts

205714 (RI)

Commercial Insurance / Payer ID Harvard

152346 (RI)

Commercial Insurance / Payer ID Ri Blue Shield

26587 (RI)

Commercial Insurance / Payer ID Neighborhood Ri

3805 (RI)

Commercial Insurance / Payer ID Aetna

5841743 (RI)

Commercial Insurance / Payer ID Cigna

1566940 (RI)

Commercial Insurance / Payer ID Tufts Group #

603940 (RI)

Hospital & Practice Group Affiliations

Refocus Eye Health Of Ri, Llc

235 Hanover St, Fall River, MA 027205299

Phone: 5086790150

Refocus Eye Health Of Ri, Llc

150 E Manning St, Providence, RI 029065109

Phone: 4012722020

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

21 Associated Practitioners

Dr. Durga Larkin , MD

Ophthalmology

NPI 1063466324

Doctor of Medicine (M.D.)

Dr. Paul Zerbinopoulos , OD

Optometrist

NPI 1154375418

Doctor of Optometry

Dr. Sarah Anis , MD

Ophthalmology

NPI 1225276678

Doctor of Medicine (M.D.)

Dr. Joseph Dowling , MD

Ophthalmology

NPI 1255317020

Doctor of Medicine (M.D.)

Dr. Michael Saccucci , MD

Optometrist

NPI 1265486526

Doctor of Medicine (M.D.)

Dr. Pranjal Thakuria , MD

Ophthalmology

NPI 1285830323

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active May 03, 2012

NPI status registered as active in NPPES database

📍

Updated Practice Location May 03, 2012

Registered at 150 E MANNING ST, PROVIDENCE, RI 029065109 (Tel: 4012722020)

📍

Updated Business Mailing Address May 03, 2012

Registered at 150 E MANNING ST, PROVIDENCE, RI 029065109 (Tel: 4012722020)

👤

Provider Name / Credentials Updated May 03, 2012

Recorded as JOHN DONAHUE, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) May 03, 2012

Ophthalmology (License #MD10345 in RI)

🟢

Initial NPI Registration & Enumeration December 22, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1164409918

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: December 22, 2005

Last Update: May 03, 2012

Sole Proprietor: No

Update or Correct Profile

Mailing Address

150 E Manning St

Providence, RI 029065109

Phone: 4012722020

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.