Individual provider Active NPI

Patrick J Noonan, DO

  • Pediatrics Physician
  • Urbana, IL
National Provider Identifier
1972892958
Registry record updated Nov 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
036145363 Issued in IL
Practice address
611 W Park St
Urbana, IL 61801-2501
Phone
(217) 383-3140
NPI assigned
Mar 30, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X 02005099A IN
Pediatrics Physician 208000000X 62036 WI
Pediatrics Physician 208000000X 036145363 IL Primary

Addresses

Primary practice location

611 W Park St
Urbana, IL 61801-2501

Mailing address

611 W Park St
Urbana, IL 61801-2501
Phone (217) 383-3140

Other practice location 1

1000 N Oak Ave
Marshfield, WI 54449-5703
Phone (715) 387-5511

Other identifiers 1

IdentifierTypeStateIssuer
1972892958MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address patrick.noonan@lutheranhealthnetwork.cernerdirect.com
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI, IN, IL3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20140911002037 WI Practitioner - Critical Care (Intensivists)Practitioner - Pediatric Medicine 7719106459 Reassigns benefits to 10 organizations
I20170815001495 IN Practitioner - Pediatric Medicine 7719106459 Reassigns benefits to 1 organization
I20180912003247 IL Practitioner - Pediatric Medicine 7719106459 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
62036WIMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital Inc CurrentSince Sep 18, 2024 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Sep 18, 2024 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Lutheran Medical Group LLC CurrentSince Aug 1, 2017 Accepting new patients
Carle Health Care Incorporated CurrentSince May 20, 2024 Accepting new patients
Flambeau Hospital Inc CurrentSince Sep 18, 2024 Accepting new patients
MCHS Hospitals Inc CurrentSince Aug 26, 2020 Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Jan 27, 2023 Accepting new patients
MCHS Hospitals Inc CurrentSince Aug 26, 2020 Accepting new patients
Flambeau Hospital Inc CurrentSince Sep 18, 2024 Accepting new patients
Marshfield Clinic Inc CurrentSince Aug 26, 2020 Accepting new patients
Lakeview Medical Center Inc of Rice Lake CurrentSince Sep 18, 2024 Accepting new patients
Lutheran Medical Group LLC CurrentSince Aug 1, 2017 Accepting new patients
Memorial Hospital Inc CurrentSince Sep 18, 2024 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince Sep 18, 2024 Accepting new patients
MCHS Hospitals Inc Current Accepting new patients
Gundersen Lutheran Medical Center Inc Current Accepting new patients
Gundersen Lutheran Medical Center, Inc CurrentSince Jan 27, 2023 Accepting new patients
Memorial Hospital Inc Past Accepting new patients

Locations

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

3534 Brooklyn Ave
Fort Wayne, IN 46809
Phone (219) 478-5180

7950 W Jefferson Blvd
Fort Wayne, IN 46804
Phone (260) 434-7088

7950 W Jefferson Blvd
Ste 210
Fort Wayne, IN 46804
Phone (260) 435-7355

6920 Pointe Inverness Way
Ste 200
Fort Wayne, IN 46804
Phone (260) 479-3514

2516 E DuPont Rd
Fort Wayne, IN 46825
Phone (260) 434-6076

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1836 South Ave
La Crosse, WI 54601
Phone (608) 788-8102

1910 South Ave
La Crosse, WI 54601
Phone (608) 775-2287

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1102 S Center Ave
Merrill, WI 54452
Phone (715) 536-3399

N3708 River Ave
Neillsville, WI 54456
Phone (715) 743-3101

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Interoperability endpoints

  • Direct secure messaging: patrick.noonan@lutheranhealthnetwork.cernerdirect.com
  • Direct secure messaging: pnoonando448871@carlehiedirect.net
  • FHIR API: https://fhir-myrecord.cerner.com/r4/67ff075a-8289-4f2d-a8eb-5dc1f0d954ab/
  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com
  • Direct secure messaging: pnoonan757712@direct.emplifyhealth.org

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

NPI Registry JSON

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

{
    "created_epoch": "1301443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762128000000",
    "number": "1972892958",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012501",
            "telephone_number": "217-383-3140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 W PARK ST",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618012501",
            "telephone_number": "217-383-3140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 N OAK AVE",
            "address_purpose": "LOCATION",
            "city": "Marshfield",
            "state": "WI",
            "postal_code": "544495703",
            "country_code": "US",
            "telephone_number": "715-387-5511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOONAN",
        "first_name": "PATRICK",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-30",
        "last_updated": "2025-11-03",
        "certification_date": "2025-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "IN",
            "license": "02005099A",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WI",
            "license": "62036",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036145363",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972892958",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "patrick.noonan@lutheranhealthnetwork.cernerdirect.com",
            "affiliation": "N",
            "endpointDescription": "AMR direct address",
            "address_1": "7950 W Jefferson Blvd Ste 210",
            "city": "Fort Wayne",
            "state": "IN",
            "country_code": "US",
            "postal_code": "468044140",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "address_1": "1000 N OAK AVE",
            "city": "Marshfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544495703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Urbana, IL

Sources for this page

Verify at the official NPI Registry.