Individual provider Active NPI

Patrick DO, M.D.

  • Diagnostic Radiology Physician
  • Roseville, CA
National Provider Identifier
1023373297
Registry record updated Dec 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
A127106 Issued in CA
Practice address
1380 Lead Hill Blvd Ste 100
Roseville, CA 95661-2941
Phone
(916) 535-2030
Fax
(916) 536-3061
NPI assigned
Jul 12, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Diagnostic Radiology Physician 2085R0202X A127106 CA Primary

Addresses

Primary practice location

1380 Lead Hill Blvd Ste 100
Roseville, CA 95661-2941

Mailing address

3400 Data Dr
Rancho Cordova, CA 95670-7956

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20170729000030 CA Practitioner - Diagnostic Radiology 0547531279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dignity Health Medical FoundationGroup PAC ID 7810800661, 1,211 clinicians

Practice addresses (Care Compare)

1380 Lead Hill Blvd
Suite 100
Roseville, CA 95661-2997
Phone (916) 535-2030

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.64 of 100Reported as apm
Quality
86.27
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Medical Foundation Current Accepting new patients
Dignity Health Medical Foundation CurrentSince Nov 23, 2020 Accepting new patients
Dignity Health Medical Foundation CurrentSince Nov 23, 2020 Accepting new patients
Dignity Health Medical Foundation Current Accepting new patients
Regents of the Univ of Ca Past Accepting new patients
Kern Radiology Medical Group, Inc Diagnostic Radiology PastSince Feb 18, 2018 Accepting new patients
Dignity Health Past Accepting new patients
Dignity Community Care Past Accepting new patients
Dignity Community Care Past Accepting new patients
Dignity Health Past Accepting new patients
Dignity Community Care Past Accepting new patients
Dignity Health Medical Foundation Past Accepting new patients
Dignity Health Past Accepting new patients

Locations

6305 Coyle Ave
Carmichael, CA 95608
Phone (916) 961-6920

2510 Airpark Dr
Ste 301
Redding, CA 96001
Phone (530) 242-3500

2380 Bechelli Ln
Redding, CA 96002
Phone (530) 226-1800

2020 Court St
Redding, CA 96001
Phone (530) 243-1236

3400 Data Dr
Rncho Cordova, CA 95670
Phone (916) 379-2726

1380 Lead Hill Blvd
Ste 100
Roseville, CA 95661
Phone (916) 535-2030

3000 Q St
Sacramento, CA 95816
Phone (916) 733-5701

1595 Soquel Dr
Ste 400
Santa Cruz, CA 95065
Phone (831) 475-1111

Organizations & group practices 13

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 13

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": "1342051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608508800000",
    "number": "1023373297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 DATA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956707956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 LEAD HILL BLVD STE 100",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956612941",
            "telephone_number": "916-535-2030",
            "fax_number": "916-536-3061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DO",
        "first_name": "PATRICK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-12",
        "last_updated": "2020-12-21",
        "certification_date": "2020-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A127106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.