Michael S Fennell (NPI# 1336101690, PAC ID# 9931195807) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DIAGNOSTIC RADIOLOGY.
| Nation Provider ID (NPI) | 1336101690 |
| PAC ID by PECOS | 9931195807 |
| Professional Enrollment ID | I20040424000212 |
| Full Name | Michael S Fennell |
| Organization Legal Name | MEDFORD RADIOLOGICAL GROUP PC |
| Address |
881 Ohare Pkwy Medford OR 97504-4005 |
| Phone Number | 5416185800 |
| Gender | M |
| Credential | MD |
| Medical School | CREIGHTON UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1993 |
| Primary Specialty | DIAGNOSTIC RADIOLOGY |
| Group Practice PAC ID | 2062303324 |
| Number of Group Practice Members | 26 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 380018 | ASANTE ROGUE REGIONAL MEDICAL CENTER |
| 380075 | PROVIDENCE MEDFORD MEDICAL CENTER |
| 380005 | ASANTE ASHLAND COMMUNITY HOSPITAL |
| 380090 | BAY AREA HOSPITAL |
| 380002 | ASANTE THREE RIVERS MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 278 Maple St, Ashland, OR 97520-1552 | 5417732493 | MEDFORD RADIOLOGICAL GROUP PC |
| 280 Maple St, Ashland, OR 97520-1552 | 5416185800 | MEDFORD RADIOLOGICAL GROUP PC |
| 1107 Crater Lake Ave, Medford, OR 97504-4005 | 5417738661 | OREGON ADVANCED IMAGING, LLC |
| 1111 Crater Lake Ave, Medford, OR 97504-6241 | 5416185800 | MEDFORD RADIOLOGICAL GROUP PC |
| 1698 E Mcandrews Rd, Medford, OR 97504-5589 | 5417732493 | MEDFORD RADIOLOGICAL GROUP PC |
| 2825 E Barnett Rd, Medford, OR 97504-8332 | 5416185800 | MEDFORD RADIOLOGICAL GROUP PC |
| 3821 Annettes Way, Medford, OR 97504-9668 | 5417732493 | MEDFORD RADIOLOGICAL GROUP PC |
| 842 E Main St, Medford, OR 97504-7134 | 5417732493 | MEDFORD RADIOLOGICAL GROUP PC |
| 881 O Hare Pkwy, Medford, OR 97504-4005 | 5417738661 | OREGON ADVANCED IMAGING, LLC |
| 881 Ohare Pkwy, Medford, OR 97504-4005 | 5416185800 | MEDFORD RADIOLOGICAL GROUP PC |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| MIPS_EC_225_overall | Radiology: Reminder System for Screening Mammograms | 100% | |
| MIPS_EC_436_overall | Radiation Consideration for Adult CT: Utilization of Dose Lowering Techniques | 100% |
| Organization Legal Name | MEDFORD RADIOLOGICAL GROUP PC |
| Physicians | 26 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Weston Jay Caywood | Diagnostic Radiology | Medford Radiological Group PC | 881 Ohare Pkwy, Medford, OR 97504-4005 |
| John N Simmons | Diagnostic Radiology | Medford Radiological Group PC | 1775 Thompson Rd, Coos Bay, OR 97420-2125 |
| Chad Micheal Ringger | Diagnostic Radiology | Medford Radiological Group PC | 1775 Thompson Rd, Coos Bay, OR 97420-2125 |
| Kristina E Darlington Hansen | Diagnostic Radiology | Medford Radiological Group PC | 1775 Thompson Rd, Coos Bay, OR 97420-2125 |
| Brett M Young | Interventional Radiology | Medford Radiological Group PC | 1775 Thompson Rd, Coos Bay, OR 97420-2125 |
| Tara L Buck | Physician Assistant | Medford Radiological Group PC | 1698 E Mcandrews Rd, Medford, OR 97504-5589 |
| James L Ockner | Diagnostic Radiology | Medford Radiological Group PC | 1775 Thompson Rd, Coos Bay, OR 97420-2125 |
| Matthew Scott Lidstrom | Diagnostic Radiology | Medford Radiological Group PC | 1775 Thompson Rd, Coos Bay, OR 97420-2125 |
| Seth M Urban | Interventional Radiology | Medford Radiological Group PC | 1775 Thompson Rd, Coos Bay, OR 97420-2125 |
| James R Hills | Diagnostic Radiology | Medford Radiological Group PC | 94220 4th St, Gold Beach, OR 97444-7756 |
| Street Address |
881 OHARE PKWY |
| City | MEDFORD |
| State | OR |
| Zip | 97504-4005 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Weston Jay Caywood | Diagnostic Radiology | Medford Radiological Group PC | 881 Ohare Pkwy, Medford, OR 97504-4005 |
| George J Lewis | Diagnostic Radiology | Medford Radiological Group PC | 881 Ohare Pkwy, Medford, OR 97504-4005 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kimberly Anne Zaslow | Family Medicine | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Benjamin Robert Oldson | Family Medicine | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Shirley A Malcolm | Osteopathic Manipulative Medicine | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Denise M Viss | Nurse Practitioner | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Carissa D Scalf | Psychologist, Clinical | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Wesley T Ramoso | Family Medicine | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Uzomechine Thabiso Chiedozi | Family Medicine | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Grant A Jolliffe | Nurse Practitioner | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Travis Adam Day | Nurse Practitioner | Providence Health and Services Oregon | 70 Bower Dr, Medford, OR 97504 |
| Jasmin Williams | Clinical Social Worker | Options for Southern Oregon | 1700 E Barnett Rd, Medford, OR 97504-0052 |
| Find all physicians in zip 97504 | |||
| City | MEDFORD |
| Zip Code | 97504 |
| Specialty | DIAGNOSTIC RADIOLOGY |
| City + Specialty | MEDFORD + DIAGNOSTIC RADIOLOGY |
Please comment or provide details below to improve the information on Michael S Fennell.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.