Individual provider Active NPI

Michael Frederick Fadell II, M.D.

  • Pediatric Radiology Physician
  • Durham, NC
National Provider Identifier
1740489350
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Radiology PhysicianTaxonomy code 2085P0229X
License
312296 Issued in NC
Practice address
2301 Erwin Road Department of Radiology
Durham, NC 27710-1601
Phone
(919) 684-7293
NPI assigned
Jul 13, 2007
Last updated
Dec 7, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Radiology Physician 2085P0229X C166708 CA
Pediatric Radiology Physician 2085P0229X 56242 AZ
Pediatric Radiology Physician 2085P0229X 312296 NC Primary
Diagnostic Radiology Physician 2085R0202X 35.086097 OH
Diagnostic Radiology Physician 2085R0202X C166708 CA

Addresses

Primary practice location

2301 Erwin Road Department of Radiology
Durham, NC 27710-1601

Mailing address

725 Welch Rd RM 1890
Palo Alto, CA 94304-1601
Phone (650) 725-2548

Other practice location 1

725 Welch Rd Rm 1890
Palo Alto, CA 94304-1601
Phone (650) 725-2548

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, NC2 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
I20200305001973 CA Practitioner - Diagnostic Radiology 7113019605
I20221114001910 NC Practitioner - Diagnostic Radiology 7113019605 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Toledo College of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Duke Health Integrated Practice IncGroup PAC ID 8325412737, 3,140 clinicians

Practice addresses (Care Compare)

2301 Erwin Rd
Durham, NC 27705-4699
Phone (919) 684-8111

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56242AZMDPediatric Radiology Physician
C166708CAMDPediatric Radiology Physician
312296NCMDPediatric Radiology Physician
35.086097OHMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Duke Health Integrated Practice, Inc. CurrentSince Jul 1, 2023 Accepting new patients
Pro Rad, Inc Diagnostic Radiology Past Accepting new patients

Locations

2301 Erwin Rd
Durham, NC 27705
Phone (919) 668-0289

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588

Organizations & group practices 2

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.

Hospital & facility affiliations 6

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": "1184284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1740489350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 WELCH RD RM 1890",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041601",
            "telephone_number": "650-725-2548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 ERWIN ROAD DEPARTMENT OF RADIOLOGY",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277101601",
            "telephone_number": "919-684-7293"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "725 Welch Rd Rm 1890",
            "address_purpose": "LOCATION",
            "city": "Palo Alto",
            "state": "CA",
            "postal_code": "943041601",
            "country_code": "US",
            "telephone_number": "650-725-2548",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FADELL",
        "first_name": "MICHAEL",
        "middle_name": "FREDERICK",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-13",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "CA",
            "license": "C166708",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "AZ",
            "license": "56242",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "NC",
            "license": "312296",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "35.086097",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "C166708",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.