Individual provider Active NPI

Mary Beth Patton, OTR

  • Specialist
  • Brookfield, WI
National Provider Identifier
1023145596
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
892026 Issued in WI
Practice address
3415 N 127TH St
Brookfield, WI 53005-3117
Phone
(262) 781-8144
Fax
(262) 781-8552
NPI assigned
Feb 28, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 892026 WI Primary

Addresses

Primary practice location

3415 N 127TH St
Brookfield, WI 53005-3117

Mailing address

1502 Saint Charles St
Wauwatosa, WI 53213-2757
Phone (414) 257-1938

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120123000314 WI Practitioner - Occupational Therapist in Private Practice 9638078926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Injury Rehabilitation Clinic II, Inc.Group PAC ID 3072412352, 4 clinicians

Practice addresses (Care Compare)

3415 N 127TH St
Suite 4
Brookfield, WI 53005-3117
Phone (262) 781-8144

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
892026WIMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Injury Rehabilitation Clinic II, Inc. CurrentSince Jan 1, 2000 Accepting new patients

Locations

3415 N 127th St
Brookfield, WI 53005
Phone (262) 781-8144

3415 N 127th St
Ste 4
Brookfield, WI 53005
Phone (262) 781-8144

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023145596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 SAINT CHARLES ST",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532132757",
            "telephone_number": "414-257-1938",
            "fax_number": "262-257-1949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 N 127TH ST",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530053117",
            "telephone_number": "262-781-8144",
            "fax_number": "262-781-8552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTON",
        "first_name": "MARY",
        "middle_name": "BETH",
        "name_prefix": "Mrs.",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "WI",
            "license": "892026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.