Active NPI
Nicholas Patchan, M.D.
- Anesthesiology Physician
- Randallstown, MD
National Provider Identifier
1154327724
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- D0054181
- Practice address
- 5401 Old Court Rd
Randallstown, MD 21133-5103 - Phone
- (410) 521-2200
- NPI assigned
- Jun 28, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | D0054181 | MD | Primary |
Addresses
Primary practice location
5401 Old Court Rd
Randallstown, MD 21133-5103
Mailing address
11781 Lee Jackson Memorial Hwy
Suite 550
Fairfax, VA 22033-3309
Phone (571) 777-5157
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 955300200 | Medicaid | MD | |
| 454MJ234 | Other | MD | TRAILBLAZER |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0054181 | MD | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bel Air Sedation, LLC | Past | Accepting new patients | |
| Northern Chesapeake Anesthesia Associates | Past | Accepting new patients | |
| North American Partners in Anesthesia (Virginia), LLC | Anesthesiology | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Specialist
- Bel Air, MD
- NPI 1215254560
-
- Ambulatory Surgical Clinic/Center
- Bel Air, MD
- NPI 1891734869
-
- Anesthesiology Physician
- Fairfax, VA
- NPI 1922031442
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1119916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444953600000",
"number": "1154327724",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11781 LEE JACKSON MEMORIAL HWY",
"address_2": "SUITE 550",
"city": "FAIRFAX",
"state": "VA",
"postal_code": "220333309",
"telephone_number": "571-777-5157",
"fax_number": "703-890-2650"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5401 OLD COURT RD",
"city": "RANDALLSTOWN",
"state": "MD",
"postal_code": "211335103",
"telephone_number": "410-521-2200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATCHAN",
"first_name": "NICHOLAS",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-28",
"last_updated": "2015-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MD",
"license": "D0054181",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "955300200",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRAILBLAZER",
"identifier": "454MJ234",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Randallstown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.