Individual provider Active NPI

Paul Joseph Farnsworth, D.O.

  • Diagnostic Radiology Physician
  • St Petersburg, FL
National Provider Identifier
1407207236
Registry record updated Aug 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
OS15272 Issued in FL
Practice address
1200 7TH Ave N
St Petersburg, FL 33705-1300
Phone
(727) 825-1100
NPI assigned
Jun 22, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X UO5229 FL
Diagnostic Radiology Physician 2085R0202X 69023 MN
Diagnostic Radiology Physician 2085R0202X OS15272 FL Primary

Addresses

Primary practice location

1200 7TH Ave N
St Petersburg, FL 33705-1300

Mailing address

PO Box 919379
Orlando, FL 32891-9379
Phone (844) 453-1406

Other practice location 1

1201 5th Ave N Ste 105
St Petersburg, FL 33705-1410
Phone (727) 825-1100

Other identifiers 3

IdentifierTypeStateIssuer
110610400MedicaidFL
XHRZUOtherFLFL BCBS
N0975OtherFLFL MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, FL2 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
I20210610000980 MN Practitioner - Diagnostic Radiology 1153721311 Reassigns benefits to 12 organizations
I20210629001017 FL Practitioner - Diagnostic Radiology 1153721311 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Nova Southeastern College of Osteo Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo ClinicGroup PAC ID 6507778255, 4,829 clinicians

Practice addresses (Care Compare)

200 1St St SW
Rochester, MN 55905-0001
Phone (507) 284-2511

Hospital & facility affiliations

  • Mayo Clinic Hospital Rochester Hospital, Rochester, MN, CCN 240010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
UO5229FLMDInternal Medicine Physician
OS15272FLMDDiagnostic Radiology Physician
69023MNMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Southeast Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Fairmont CurrentSince Jul 4, 2022 Accepting new patients
Mayo Clinic CurrentSince Jul 1, 2021 Accepting new patients
St. Anthony'S Professional Buildings & Services, Inc Diagnostic Radiology CurrentSince Jun 25, 2021 Accepting new patients
Mayo Clinic Health System-Lake City Current Accepting new patients
Mayo Clinic CurrentSince Jul 1, 2021 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Jul 4, 2022 Accepting new patients
Mayo Clinic Current Accepting new patients
St. Anthony'S Professional Buildings & Services, Inc Current Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region Current Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region CurrentSince Jul 4, 2022 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region Current Accepting new patients
Mayo Clinic Health System-St James Current Accepting new patients
Radiology Associates of St. Petersburg PA Diagnostic Radiology CurrentSince Jul 1, 2021 Accepting new patients
Mayo Clinic Health System-Southeast Minnesota Region CurrentSince Jul 4, 2022 Accepting new patients
Mayo Clinic Health System-St James CurrentSince Jul 4, 2022 Accepting new patients
St. Anthony'S Professional Buildings & Services, Inc Diagnostic Radiology CurrentSince Jun 25, 2021 Accepting new patients
Mayo Clinic Health System-Lake City CurrentSince Jul 4, 2022 Accepting new patients
Mayo Clinic Health System-Southwest Minnesota Region Current Accepting new patients

Locations

1200 7th Ave N
St Petersburg, FL 33705
Phone (727) 820-7764

620 10th St N
Ste 100
St Petersburg, FL 33705
Phone (727) 502-4200

900 Carillon Pkwy
St Petersburg, FL 33716
Phone (727) 556-2662

1201 5th Ave N
Ste 105
St Petersburg, FL 33705

404 W Fountain St
Albert Lea, MN 56007
Phone (507) 377-6285

32021 County 24 Blvd
Cannon Falls, MN 55009
Phone (507) 263-6000

800 Medical Center Dr
Fairmont, MN 56031
Phone (507) 238-8100

500 W Grant St
Lake City, MN 55041
Phone (651) 345-3321

1025 Marsh St
Mankato, MN 56001
Phone (507) 345-2623

301 2nd St NE
New Prague, MN 56071
Phone (952) 758-4431

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

1101 Moulton and Parsons Dr
Saint James, MN 56081
Phone (507) 375-3261

501 State St N
Waseca, MN 56093
Phone (507) 835-1210

Organizations & group practices 19

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.

View all 19

Hospital & facility affiliations 1

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": "1466553600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1407207236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 919379",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328919379",
            "telephone_number": "844-453-1406",
            "fax_number": "772-621-3180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 7TH AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337051300",
            "telephone_number": "727-825-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 5th Ave N Ste 105",
            "address_purpose": "LOCATION",
            "city": "St Petersburg",
            "state": "FL",
            "postal_code": "337051410",
            "country_code": "US",
            "telephone_number": "727-825-1100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FARNSWORTH",
        "first_name": "PAUL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-06-22",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "UO5229",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MN",
            "license": "69023",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "FL",
            "license": "OS15272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110610400",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL BCBS",
            "identifier": "XHRZU",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FL MEDICARE",
            "identifier": "N0975",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

Verify at the official NPI Registry.