Patrick J Cavanagh, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036096619 Issued in IL

Practice address

550 Southland Dr
Ste 2
Decatur, IL 62521-4080

Phone

(217) 425-9264

Fax

(217) 425-5983

NPI assigned

Apr 26, 2006

Last updated

Aug 20, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Siu Physicians & Surgeons, Inc

  dba SIU HealthCare

  • Endocrinology, Diabetes & Metabolism Physician
  • Springfield, IL
  • NPI 1558385989

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408492800000",
    "number": "1669439584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 N EDWARD ST",
            "address_2": "GSBLL",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625264163",
            "telephone_number": "217-425-9264",
            "fax_number": "217-425-5983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 SOUTHLAND DR",
            "address_2": "STE 2",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625214080",
            "telephone_number": "217-425-9264",
            "fax_number": "217-425-5983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVANAGH",
        "first_name": "PATRICK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-26",
        "last_updated": "2014-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036096619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036096619",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carrie Casch
• Kimberly A Casteel
• Alexandria Castracane, PHARMD
• Catholic Charities
• Cathy Ahlrich
• Dena Cearlock
• Center for Cosmetic Medicine, LTD.
• Center for Neurobehavioral Disorders, LLC
• Center for Sight Central Il I SC
• Center for Sight of Central Illinois SC (Central Illinois Vision Center)

• Family Medicine Physician in Decatur, IL
• Providers in Decatur, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.