NPIMap

Individual provider Active NPI

Michael J. Farrell IV, D.O.

  • Geriatric Medicine (Internal Medicine) Physician
  • Heber City, UT
National Provider Identifier
1619264397
Registry record updated Oct 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
10074148-1204 Issued in UT
Practice address
520 N Main St Ste 336
Heber City, UT 84032-1216
Phone
(801) 397-4040
NPI assigned
Jul 1, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 10074148-1204 UT
Family Medicine Physician 207Q00000X 20A12688 CA
Addiction Medicine (Family Medicine) Physician 207QA0401X 10074148-1204 UT
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 10074148-1204 UT Primary

Addresses

Primary practice location

520 N Main St Ste 336
Heber City, UT 84032-1216

Mailing address

520 N Main St Ste 336
Heber City, UT 84032-1216
Phone (801) 397-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, UT, WY3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20130819000560 CA Practitioner - Family Practice 8224270426 Reassigns benefits to 1 organization
I20180207001153 UT Practitioner - Internal MedicinePractitioner - Family PracticePractitioner - Addiction Medicine 8224270426 Reassigns benefits to 3 organizations
I20191122001124 WY Practitioner - Geriatric MedicinePractitioner - Family Practice 8224270426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Addiction Medicine, Family Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

544 E 1200
Heber City, UT 84032-4497
Phone (435) 400-1051

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Rocky Mountain Care - Palliative Care LLC CurrentSince May 1, 2024 Accepting new patients
University of Utah Adult Services CurrentSince Jan 6, 2018 Accepting new patients
University of Utah Adult Services Current Accepting new patients
University of Utah Adult Services CurrentSince Jan 6, 2018 Accepting new patients

Locations

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

598 W 900 S
Ste 220
Woods Cross, UT 84010
Phone (801) 693-2310

576 W 900 S
Ste 103
Woods Cross, UT 84010
Phone (801) 693-2380

598 W 900 S
Ste 105
Woods Cross, UT 84010
Phone (801) 693-4040

576 W 900 S
Ste 260
Woods Cross, UT 84010
Phone (801) 397-4054

Interoperability endpoints

  • Direct secure messaging: michael.farrell@hdmg.eclinicaldirectplus.com

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Carechoices Hospice and Palliative Services, LLCIrvine, CA, CCN 551529 Hospice Contracted Managing Employee (33.3%) Apr 1, 2025

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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.

Hospital & facility affiliations 5

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": "1309478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633478400000",
    "number": "1619264397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 N MAIN ST STE 336",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "840321216",
            "telephone_number": "801-397-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N MAIN ST STE 336",
            "city": "HEBER CITY",
            "state": "UT",
            "postal_code": "840321216",
            "telephone_number": "801-397-4040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARRELL",
        "first_name": "MICHAEL",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-07-01",
        "last_updated": "2021-10-06",
        "certification_date": "2021-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "10074148-1204",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A12688",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "UT",
            "license": "10074148-1204",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "UT",
            "license": "10074148-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Heber City, UT

Sources for this page

Verify at the official NPI Registry.