NPIMap

Individual provider Active NPI

Timothy Farrell, MD

  • Family Medicine Physician
  • Pawtucket, RI
National Provider Identifier
1306959747
Registry record updated Oct 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD12351 Issued in RI
Practice address
407 East Ave
University Medicine Geriatrics Practice
Pawtucket, RI 02860-5299
Phone
(401) 728-7270
Fax
(401) 728-6453
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2021

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 LP00143 RI
Family Medicine Physician 207Q00000X 7272237-1205 UT
Family Medicine Physician 207Q00000X MD12351 RI Primary

Addresses

Primary practice location

407 East Ave
University Medicine Geriatrics Practice
Pawtucket, RI 02860-5299

Mailing address

111 Brewster Street
FCC Team a
Pawtucket, RI 02860
Phone (401) 729-3469

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tfarrell6481@direct.med.utah.edu Direct UNIVERSITY OF UTAH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090922000169 UT Practitioner - Geriatric Medicine 4183770852 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Geriatric Medicine
Education
University of Massachusetts Medical School, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians

Practice addresses (Care Compare)

50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 213-2995

Hospital & facility affiliations

  • Community Nursing Services Home health agency, West Valley City, UT, CCN 467001
  • University of Utah Hospital and Clinics Hospital, Salt Lake City, UT, CCN 460009

Merit-based Incentive Payment System (MIPS)

Final score
89.77 of 100Reported as group
Quality
91.47
Promoting interoperability
100
Improvement activities
40
Cost
74.42

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LP00143RIMDFamily Medicine Physician
MD12351RIMDFamily Medicine Physician
7272237-1205UTMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Community Physicians Group Family Medicine Current Accepting new patients
University of Utah Community Physicians Group CurrentSince Feb 1, 2015 Accepting new patients
University of Utah Adult Services Current Accepting new patients
University of Utah Community Physicians Group Family Medicine CurrentSince Feb 1, 2015 Accepting new patients
University of Utah Adult Services CurrentSince Apr 1, 2015 Accepting new patients
University of Utah Adult Services CurrentSince Apr 1, 2015 Accepting new patients
Bronson Lakeview Hospital Family Medicine Past Accepting new patients
University Primary Care Sports Med Past Accepting new patients

Locations

1525 W 2100 S
Salt Lake City, UT 84119
Phone (801) 213-8841

555 Foothill Dr
Slc, UT 84112
Phone (801) 581-7589

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Organizations & group practices 9

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": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635206400000",
    "number": "1306959747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 BREWSTER STREET",
            "address_2": "FCC TEAM A",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "02860",
            "telephone_number": "401-729-3469",
            "fax_number": "401-729-2541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "407 EAST AVE",
            "address_2": "UNIVERSITY MEDICINE GERIATRICS PRACTICE",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028605299",
            "telephone_number": "401-728-7270",
            "fax_number": "401-728-6453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRELL",
        "first_name": "TIMOTHY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "LP00143",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "7272237-1205",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "MD12351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tfarrell6481@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "UNIVERSITY OF UTAH",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pawtucket, RI

Sources for this page

Verify at the official NPI Registry.