Individual provider Active NPI

Jared J Patton, PA-C

  • Physician Assistant
  • Union, KY
National Provider Identifier
1194004515
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1669 Issued in KY
Practice address
605 Man O War Boulevard
Union, KY 41091-2007
Phone
(859) 578-5669
Fax
(859) 384-0091
NPI assigned
Aug 16, 2011
Last updated
Oct 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 10003135A IN
Physician Assistant 363A00000X PA1669 KY Primary

Addresses

Primary practice location

605 Man O War Boulevard
Union, KY 41091-2007

Mailing address

PO Box 635283
Cincinnati, OH 45263-5283
Phone (859) 905-3070

Other practice location 1

85 N Grand Ave
Fort Thomas, KY 41075-1793
Phone (859) 572-3617

Other practice location 2

1400 Grand Ave
Newport, KY 41071-2570
Phone (859) 905-3070

Other practice location 3

1640 Flossie Dr
Greendale, IN 47025-8424
Phone (812) 496-3285

Other identifiers 1

IdentifierTypeStateIssuer
7100230030MedicaidKY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, IN2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120329000880 KY Practitioner - Physician Assistant 3173783032 Reassigns benefits to 2 organizations
I20201204001895 IN Practitioner - Physician Assistant 3173783032 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Medical Group IncGroup PAC ID 2163326240, 803 clinicians

Practice addresses (Care Compare)

1400 Grand Ave
Newport, KY 41071-2570
Phone (859) 301-5901

1640 Flossie Dr
Greendale, IN 47025-8424
Phone (855) 277-4230

2626 Alexandria Pike
Highland Heights, KY 41076-1530
Phone (859) 301-5901

300 Barnes Rd
Williamstown, KY 41097-9483
Phone (859) 824-8400

334 Thomas More Pkwy
Suite 200
Crestview Hills, KY 41017-3496
Phone (859) 344-3737

405 Violet Rd
Crittenden, KY 41030-8956
Phone (859) 301-5901

PO Box
Suite 635283
Cincinnati, OH 45263-5283

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

Merit-based Incentive Payment System (MIPS)

Final score
93.13 of 100Reported as group
Quality
89.38
Improvement activities
40
Cost
79.98

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
10003135AINMDPhysician Assistant
PA1669KYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Medical Group, Inc. CurrentSince Oct 14, 2024 Accepting new patients
Summit Medical Group, Inc. Physician Assistant CurrentSince Oct 14, 2024 Accepting new patients
Summit Medical Group, Inc Physician Assistant CurrentSince Oct 14, 2024 Accepting new patients

Locations

204 Bridgeway St
Aurora, IN 47001
Phone (812) 926-3133

1640 Flossie Dr
Lawrenceburg, IN 47025
Phone (812) 496-3285

600 Wilson Creek Rd
Lawrenceburg, IN 47025
Phone (812) 532-2700

334 Thomas More Pkwy
Ste 200
Crestview Hills, KY 41017
Phone (859) 344-3737

85 N Grand Ave
Fort Thomas, KY 41075
Phone (859) 572-3100

1400 Grand Ave
Newport, KY 41071
Phone (859) 905-3070

605 Man O War Blvd
Union, KY 41091
Phone (859) 578-5333

300 Barnes Rd
Williamstown, KY 41097
Phone (859) 824-8217

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1313452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1194004515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 635283",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452635283",
            "telephone_number": "859-905-3070",
            "fax_number": "859-441-1348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 MAN O WAR BOULEVARD",
            "city": "UNION",
            "state": "KY",
            "postal_code": "410912007",
            "telephone_number": "859-578-5669",
            "fax_number": "859-384-0091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "85 N Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Fort Thomas",
            "state": "KY",
            "postal_code": "410751793",
            "country_code": "US",
            "telephone_number": "859-572-3617",
            "fax_number": "859-572-2366",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Newport",
            "state": "KY",
            "postal_code": "410712570",
            "country_code": "US",
            "telephone_number": "859-905-3070",
            "fax_number": "859-441-1348",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1640 Flossie Dr",
            "address_purpose": "LOCATION",
            "city": "Greendale",
            "state": "IN",
            "postal_code": "470258424",
            "country_code": "US",
            "telephone_number": "812-496-3285",
            "fax_number": "812-537-0400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATTON",
        "first_name": "JARED",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-16",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IN",
            "license": "10003135A",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "PA1669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100230030",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union, KY

Sources for this page

Verify at the official NPI Registry.