Individual provider Active NPI

Patrick Dunleavy Farrell, D.O.

  • Family Medicine Physician
  • Frederick, MD
National Provider Identifier
1053765487
Registry record updated Sep 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H0098041 Issued in MD
Practice address
9093 Ridgefield Dr Ste 104
Frederick, MD 21701-6711
Phone
(301) 682-4100
NPI assigned
Apr 22, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2018020870 MO
Family Medicine Physician 207Q00000X 125069142 IL
Family Medicine Physician 207Q00000X H0098041 MD Primary

Addresses

Primary practice location

9093 Ridgefield Dr Ste 104
Frederick, MD 21701-6711

Mailing address

3 Saint Elizabeth Blvd Ste 4000
O Fallon, IL 62269-1284
Phone (618) 233-5480

Other practice location 1

180 S 3rd St
Suite 300
Belleville, IL 62220-1952
Phone (618) 233-5480

Other practice location 2

3 Saint Elizabeth Blvd Ste 4000
O Fallon, IL 62269
Phone (618) 233-5480 ext. 44322

Other practice location 3

300 1st Capitol Dr
Saint Charles, MO 63301-2844
Phone (636) 947-5000

Other practice location 4

100 Medical Plz
Lake St Louis, MO 63367-1366
Phone (636) 625-5200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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 1

Enrollment IDStateProvider typePAC IDDetails
I20230925003333 MD Practitioner - Family Practice 4284922303 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125069142ILMDFamily Medicine Physician
H0098041MDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Care Center LLC Current Accepting new patients
Privia Care Center LLC CurrentSince Sep 1, 2023 Accepting new patients
Privia Medical Group, LLC CurrentSince Sep 1, 2023 Accepting new patients
Privia Medical Group, LLC Family Medicine CurrentSince Sep 1, 2023 Accepting new patients
Menocal Medical Services PA Family Medicine Current Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

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

301 Saint Paul St
Ste 409
Baltimore, MD 21202
Phone (410) 659-7041

110 Baughmans Ln
Ste 140
Frederick, MD 21702
Phone (240) 215-1138

9093 Ridgefield Dr
Ste 104
Frederick, MD 21701
Phone (240) 913-5950

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

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1461283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695686400000",
    "number": "1053765487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 SAINT ELIZABETH BLVD STE 4000",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691284",
            "telephone_number": "618-233-5480",
            "fax_number": "618-222-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9093 RIDGEFIELD DR STE 104",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217016711",
            "telephone_number": "301-682-4100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "180 S 3rd St",
            "address_2": "Suite 300",
            "address_purpose": "LOCATION",
            "city": "Belleville",
            "state": "IL",
            "postal_code": "622201952",
            "country_code": "US",
            "telephone_number": "618-233-5480",
            "fax_number": "618-222-4790",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3 Saint Elizabeth Blvd Ste 4000",
            "address_purpose": "LOCATION",
            "city": "O Fallon",
            "state": "IL",
            "postal_code": "62269",
            "country_code": "US",
            "telephone_number": "618-233-5480 x44322",
            "fax_number": "618-222-4790",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 1st Capitol Dr",
            "address_purpose": "LOCATION",
            "city": "Saint Charles",
            "state": "MO",
            "postal_code": "633012844",
            "country_code": "US",
            "telephone_number": "636-947-5000",
            "fax_number": "636-947-5090",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Medical Plz",
            "address_purpose": "LOCATION",
            "city": "Lake St Louis",
            "state": "MO",
            "postal_code": "633671366",
            "country_code": "US",
            "telephone_number": "636-625-5200",
            "fax_number": "636-625-5314",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARRELL",
        "first_name": "PATRICK",
        "middle_name": "DUNLEAVY",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-22",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2018020870",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "125069142",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "H0098041",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.