Lawrence John Fanelly Jr., DO

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

34003344F Issued in OH

Practice address

2600 Navarre Ave
Oregon, OH 43616-3207

Phone

(419) 696-7216

Fax

(419) 696-2123

NPI assigned

Jan 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OH

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

Specialty

Pathology

Education

Ohio State University College of Medicine, 1977

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Consulting Pathologists CorpGroup PAC ID 3577597277, 7 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy St Vincent Medical Center Hospital, Toledo, OH, CCN 360112
• Mercy Health - Defiance Hospital Hospital, Defiance, OH, CCN 360270
• Mercy Health - Tiffin Hospital Hospital, Tiffin, OH, CCN 360089

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Consulting Pathologists Corp

  • Anatomic Pathology & Clinical Pathology Physician
  • Toledo, OH
  • NPI 1740288471
  Medicare reassignment Care Compare group NPD
• MRG Associates, LLC

  • Diagnostic Radiology Physician
  • Toledo, OH
  • NPI 1912264680
  NPD

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

• Mercy Health - Defiance Hospital LLC

  • General Acute Care Hospital
  • Defiance, OH
  • NPI 1629011234
  Care Compare affiliation
• Mercy Health - St Vincent Medical Center LLC

  • General Acute Care Hospital
  • Toledo, OH
  • NPI 1467493551
  Care Compare affiliation
• Mercy Health - Tiffin Hospital LLC

  • General Acute Care Hospital
  • Tiffin, OH
  • NPI 1316994734
  Care Compare affiliation

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505433600000",
    "number": "1285614503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1188",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434021188",
            "telephone_number": "419-698-9711",
            "fax_number": "419-698-2841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 NAVARRE AVE",
            "city": "OREGON",
            "state": "OH",
            "postal_code": "436163207",
            "telephone_number": "419-696-7216",
            "fax_number": "419-696-2123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANELLY",
        "first_name": "LAWRENCE",
        "middle_name": "JOHN",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-20",
        "last_updated": "2017-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "OH",
            "license": "34003344F",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3402510110",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0494924",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robin L Evearitt
• John Joseph Evola, D.D.S.
• Chantal Denise Fair, COTAL
• Emily Faltin, PHARMD, MBA
• Family Internists of Ohio, Inc.
• Andrea Farrell
• Rawish Fatima, MD
• Amanda Feher-Konczal, PT
• Wilfred James Fennewald, LICENSED OPTICIAN
• Fergosey, Inc.

• Anatomic Pathology & Clinical Pathology Physician in Oregon, OH
• Providers in Oregon, OH by specialty
• Anatomic Pathology & Clinical Pathology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.