NPIMap

Individual provider Active NPI

Samuel Farrell, MD

  • Internal Medicine Physician
  • Travis AFB, CA
National Provider Identifier
1043742570
Registry record updated Nov 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0101266361 Issued in VA
Practice address
101 Bodin Cir
Travis AFB, CA 94535-1809
Phone
(707) 423-3000
NPI assigned
Apr 3, 2017
Last updated
Nov 1, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2023

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 0101266361 VA Primary

Addresses

Primary practice location

101 Bodin Cir
Travis AFB, CA 94535-1809

Mailing address

101 Bodin Cir
Travis AFB, CA 94535-1809
Phone (707) 423-3000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, VA2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250314001891 CO Practitioner - Internal Medicine 0840616975 Reassigns benefits to 2 organizations
I20250805004085 VA Practitioner - Internal Medicine 0840616975 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Tennessee, HSC, College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aspen Valley Hospital DistrictGroup PAC ID 9234123266, 38 clinicians
Vituity-Virginia Hospitalists PCGroup PAC ID 6507245131, 109 clinicians

Practice addresses (Care Compare)

401 Castle Creek Rd
Aspen, CO 81611-1159
Phone (970) 544-1120

5801 Bremo Rd
Richmond, VA 23226-1907
Phone (804) 285-2011

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0101266361VAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aspen Valley Hospital Clinics, PLLC Internal Medicine Current Accepting new patients
Aspen Valley Hospital District Clinics CurrentSince Mar 17, 2025 Accepting new patients
Vituity-Virginia Hospitalists PC CurrentSince Jul 1, 2025 Accepting new patients
Aspen Valley Hospital District CurrentSince Mar 17, 2025 Accepting new patients
Aspen Valley Hospital District CurrentSince Mar 17, 2025 Accepting new patients

Locations

2100 Powell St
Ste 400
Emeryville, CA 94608
Phone (510) 350-2638

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 350-2663

401 Castle Creek Rd
Aspen, CO 81611
Phone (970) 544-1192

1460 E Valley Rd
Ste 103
Basalt, CO 81621
Phone (970) 279-4111

5801 Bremo Rd
Richmond, VA 23226
Phone (804) 281-8220

Interoperability endpoints

  • FHIR API: https://epicproxy.et1254.epichosted.com/FHIRProxy/api/FHIR/R4/

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1491177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1043742570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-3000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 BODIN CIR",
            "city": "TRAVIS AFB",
            "state": "CA",
            "postal_code": "945351809",
            "telephone_number": "707-423-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRELL",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-03",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0101266361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Travis AFB, CA

Sources for this page

Verify at the official NPI Registry.