Individual provider Active NPI

Bernard E Patty, MD

  • Ophthalmology Physician
  • Alexandria, LA
National Provider Identifier
1033170303
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
011191 Issued in LA
Practice address
231 Windermere Blvd
Alexandria, LA 71303-3538
Phone
(318) 487-2020
Fax
(318) 445-7745
NPI assigned
Mar 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 011191 LA Primary

Addresses

Primary practice location

231 Windermere Blvd
Alexandria, LA 71303-3538

Mailing address

231 Windermere Blvd
Alexandria, LA 71303
Phone (318) 487-2020

Other identifiers 2

IdentifierTypeStateIssuer
1154369MedicaidLA
P00169986OtherTRAVELERS MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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
I20041218000001 LA Practitioner - Ophthalmology 7618874801 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
011191LAMDOphthalmology Physician

Networks

  • LA PPO C-SNP

Organizations & group practices 2

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": "1143504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348704000000",
    "number": "1033170303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 WINDERMERE BLVD",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "71303",
            "telephone_number": "318-487-2020",
            "fax_number": "318-445-7745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 WINDERMERE BLVD",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713033538",
            "telephone_number": "318-487-2020",
            "fax_number": "318-445-7745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTY",
        "first_name": "BERNARD",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-28",
        "last_updated": "2012-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "LA",
            "license": "011191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154369",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS MEDICARE",
            "identifier": "P00169986",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

Verify at the official NPI Registry.