Individual provider Active NPI

Fredrick Oakley, M.D., PH. D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Rock Island, IL
National Provider Identifier
1235429085
Registry record updated Mar 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
036.142587 Issued in IL
Practice address
2701 17TH St
Rock Island, IL 61201-5351
Phone
(093) 779-2127
Fax
(309) 779-2137
NPI assigned
Apr 13, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 036.142587 IL Primary

Addresses

Primary practice location

2701 17TH St
Rock Island, IL 61201-5351

Mailing address

2146 Belcourt Ave
Nashville, TN 37212-3504

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, IA2 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
I20170801003024 IL Practitioner - Pathology 5395048250 Reassigns benefits to 1 organization
I20180713002776 IA Practitioner - Pathology 5395048250 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
University of Iowa, RJ & L Carver College of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peoria Tazewell Pathology Group, S.C.Group PAC ID 1254228711, 17 clinicians

Practice addresses (Care Compare)

210 W Walnut St
Canton, IL 61520-2444
Phone (309) 647-5240

221 NE Glen Oak Ave
Peoria, IL 61636-0001
Phone (309) 672-4918

2701 17TH St
Rock Island, IL 61201-5351
Phone (309) 779-5286

4500 Utica Ridge Rd
Bettendorf, IA 52722-1626
Phone (563) 742-2724

500 John Deere Rd
Moline, IL 61265-6892
Phone (309) 779-5786

Hospital & facility affiliations

  • Trinity Rock Island Hospital, Rock Island, IL, CCN 140280
  • Trinity Muscatine Hospital, Muscatine, IA, CCN 160013
  • Trinity - Bettendorf Hospital, Bettendorf, IA, CCN 160104
  • Carle Health Methodist Hospital Hospital, Peoria, IL, CCN 140209

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.142587ILMDAnatomic Pathology & Clinical Pathology Physician

Organizations & group practices 1

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.

Hospital & facility affiliations 4

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": "1302652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615161600000",
    "number": "1235429085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2146 BELCOURT AVE",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372123504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 17TH ST",
            "city": "ROCK ISLAND",
            "state": "IL",
            "postal_code": "612015351",
            "telephone_number": "093-779-2127",
            "fax_number": "309-779-2137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OAKLEY",
        "first_name": "FREDRICK",
        "credential": "M.D., PH. D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-13",
        "last_updated": "2021-03-08",
        "certification_date": "2021-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "036.142587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Island, IL

Sources for this page

Verify at the official NPI Registry.