Tracie Farrell Dodig, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

43498 Issued in MN

Practice address

14001 Ridgedale Dr
#100
Minnetonka, MN 55305-1781

Phone

(952) 473-0211

Fax

(952) 473-7908

NPI assigned

Feb 7, 2006

Sex

Female

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

Other names 1

• Tracie Anne Farrell Former name

Medicare fee-for-service enrollment

Enrolled in MN

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 1

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 and National Provider Directory roles.

• Wayzata Children'S Clinic P.a.

  • Pediatrics Physician
  • Minnetonka, MN
  • NPI 1023081577
  NPD (past)

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

{
    "created_epoch": "1139270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522627200000",
    "number": "1902878408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14001 RIDGEDALE DR",
            "address_2": "#100",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051781",
            "telephone_number": "952-473-0211",
            "fax_number": "952-473-7908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14001 RIDGEDALE DR",
            "address_2": "#100",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553051781",
            "telephone_number": "952-473-0211",
            "fax_number": "952-473-7908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DODIG",
        "first_name": "TRACIE",
        "middle_name": "FARRELL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-07",
        "last_updated": "2018-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "43498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "087214800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRACIE",
            "last_name": "FARRELL",
            "middle_name": "ANNE",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Alexandra R Dixon
• Kylie Sara Dixson, M.D.
• Dale Thomas Dobrin, M.D.
• Doctopher & Co LLC
• Doctors at Home PC
• Erin Rose Dolan, M.S., A.T.R., L.P.C.
• Jasmine Lee Dolan, DNP, FNP-BC
• Joseph Andrew Dolan, MD
• Diana Marie Dombrowski, DNP
• Don Sealock, O.D., P.a.

• Pediatrics Physician in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Pediatrics Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.