Individual provider Active NPI

Kathleen Frekko Farrell, M.D.

  • Internal Medicine Physician
  • Gaithersburg, MD
National Provider Identifier
1033328430
Registry record updated Jul 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0061466 Issued in MD
Practice address
818 West Diamond Avenue
Ste 130
Gaithersburg, MD 20878
Phone
(301) 948-8780
Fax
(301) 519-9093
NPI assigned
May 22, 2007
Last updated
Jul 31, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0061466 MD Primary

Addresses

Primary practice location

818 West Diamond Avenue
Ste 130
Gaithersburg, MD 20878

Mailing address

818 West Diamond Avenue
Ste 130
Gaithersburg, MD 20878
Phone (301) 948-8780

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20081001000295 DC Practitioner - Internal Medicine 6406924620 Reassigns benefits to 2 organizations
I20150316001550 MD Practitioner - Internal Medicine 6406924620 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Georgetown University School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Privia Care Center LLCGroup PAC ID 3274801139, 286 clinicians

Practice addresses (Care Compare)

4910 Massachusetts Ave NW
Suite 114 Grady DC Office
Washington, DC 20016-4384
Phone (202) 686-0813

656 Quince Orchard Rd
Suite 100
Gaithersburg, MD 20878-1423
Phone (301) 948-8780

818 W Diamond Ave
Suite 130
Gaithersburg, MD 20878-1417
Phone (301) 948-8780

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0061466MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC Internal Medicine CurrentSince Feb 24, 2015 Accepting new patients
Privia Care Center LLC Internal Medicine CurrentSince Oct 4, 2018 Accepting new patients
Privia Care Center LLC Internal Medicine CurrentSince Oct 4, 2018 Accepting new patients
Privia Medical Group, LLC CurrentSince Feb 24, 2015 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

4910 Massachusetts Ave NW
Ste 114
Washington, DC 20016
Phone (202) 244-0812

133 Defense Hwy
Ste 112
Annapolis, MD 21401
Phone (410) 573-0140

818 W Diamond Ave
Ste 130
Gaithersburg, MD 20878
Phone (301) 762-7723

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

11350 Pembrooke Sq
Ste 304
Waldorf, MD 20603
Phone (301) 856-2810

950 N Glebe Rd
Ste 4000
Arlington, VA 22203
Phone (301) 593-9011

Interoperability endpoints

  • Direct secure messaging: kathleen.farrell.1@8042.direct.athenahealth.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343692800000",
    "number": "1033328430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 WEST DIAMOND AVENUE",
            "address_2": "STE 130",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "20878",
            "telephone_number": "301-948-8780",
            "fax_number": "301-519-9093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 WEST DIAMOND AVENUE",
            "address_2": "STE 130",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "20878",
            "telephone_number": "301-948-8780",
            "fax_number": "301-519-9093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRELL",
        "first_name": "KATHLEEN",
        "middle_name": "FREKKO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2012-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0061466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

Verify at the official NPI Registry.