Individual provider Active NPI

Jonathan L Patterson, M.D.

  • Diagnostic Radiology Physician
  • Milton, DE
National Provider Identifier
1053391953
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
C10004811 Issued in DE
Practice address
611 Federal St Ste 4
Milton, DE 19968-1157
Phone
(302) 684-5151
Fax
(302) 684-1977
NPI assigned
Jan 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X D0065095 MD
Diagnostic Ultrasound Physician 2085U0001X C10004811 DE
Body Imaging PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2085B0100X C10004811 DE
Diagnostic Neuroimaging (Radiology) Physician 2085D0003X C10004811 DE
Pediatric Radiology Physician 2085P0229X C10004811 DE
Diagnostic Radiology Physician 2085R0202X C10004811 DE Primary

Addresses

Primary practice location

611 Federal St Ste 4
Milton, DE 19968-1157

Mailing address

611 Federal St Ste 4
Milton, DE 19968-1157
Phone (302) 684-5151

Other identifiers 1

IdentifierTypeStateIssuer
200064773MedicaidDE

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL 3026841977 Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DE
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
I20090309000443 DE Practitioner - Diagnostic RadiologyPractitioner - Interventional Radiology 0840356358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Interventional Radiology
Education
Georgetown University School of Medicine, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

611 Federal St
Suite 4
Milton, DE 19968-1157
Phone (302) 684-5151

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0065095MDMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ocean Medical Imaging of Delaware, Inc. Single Specialty CurrentSince Feb 5, 2009 Accepting new patients

Locations

611 Federal St
Ste 4
Milton, DE 19968
Phone (302) 684-5151

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": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1053391953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 FEDERAL ST STE 4",
            "city": "MILTON",
            "state": "DE",
            "postal_code": "199681157",
            "telephone_number": "302-684-5151",
            "fax_number": "302-684-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 FEDERAL ST STE 4",
            "city": "MILTON",
            "state": "DE",
            "postal_code": "199681157",
            "telephone_number": "302-684-5151",
            "fax_number": "302-684-1977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "JONATHAN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MD",
            "license": "D0065095",
            "primary": false
        },
        {
            "code": "2085U0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Ultrasound",
            "state": "DE",
            "license": "C10004811",
            "primary": false
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Body Imaging",
            "state": "DE",
            "license": "C10004811",
            "primary": false
        },
        {
            "code": "2085D0003X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Neuroimaging",
            "state": "DE",
            "license": "C10004811",
            "primary": false
        },
        {
            "code": "2085P0229X",
            "taxonomy_group": "",
            "desc": "Radiology, Pediatric Radiology",
            "state": "DE",
            "license": "C10004811",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "DE",
            "license": "C10004811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200064773",
            "state": "DE"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "3026841977",
            "affiliation": "N",
            "endpointDescription": "fax",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "fax",
            "address_1": "611 Federal St Ste 4",
            "city": "Milton",
            "state": "DE",
            "country_code": "US",
            "postal_code": "199681157",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Milton, DE

Sources for this page

Verify at the official NPI Registry.