Individual provider Active NPI

Patricio L Lauder, M.D.

  • Anesthesiology Physician
  • Lodi, CA
National Provider Identifier
1194751537
Registry record updated Jul 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A64160 Issued in CA
Practice address
975 S Fairmont Ave
Lodi, CA 95240-5118
Phone
(408) 500-1186
Fax
(408) 847-1460
NPI assigned
Jun 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X A64160 CA Primary

Addresses

Primary practice location

975 S Fairmont Ave
Lodi, CA 95240-5118

Mailing address

210 N Tustin Ave
Santa Ana, CA 92705-3807
Phone (714) 347-1010

Other identifiers 1

IdentifierTypeStateIssuer
00A641601MedicaidCA

Other names 1

  • Patricio L Lauder Professional name

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
I20060117001016 CA Practitioner - Anesthesiology 6800810896 Reassigns benefits to 4 organizations
Practice locations: Hollister, CA

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sacsolano Anesthesia Exchange Medical Group, IncGroup PAC ID 9537382882, 32 clinicians
Cep America - Anesthesia PCGroup PAC ID 3678897915, 849 clinicians

Practice addresses (Care Compare)

3315 Watt Ave
Sacramento, CA 95821-3600
Phone 91648168001234

975 S Fairmont Ave
Lodi, CA 95240-5118
Phone (209) 334-3411

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
64160CAMDPharmacist
A64160CAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cep America - Anesthesia PC Anesthesiology CurrentSince Mar 11, 2017 Accepting new patients
Cep America - Anesthesia PC Anesthesiology CurrentSince Mar 11, 2017 Accepting new patients
Cep America - Anesthesia, PC Anesthesiology Current Accepting new patients
Premier Anesthesia of California, PC Anesthesiology CurrentSince Oct 31, 2012 Accepting new patients
Caringhand Home Health Solutions Inc Current Accepting new patients
DHP Anesthesia Medical Group Inc Anesthesiology Past Accepting new patients
Central California Anesthesiology Solutions Past Accepting new patients
Fairfield on-Call Specialists PC Anesthesiology Past Accepting new patients

Locations

2100 Powell St
Ste 900
Emeryville, CA 94608
Phone (510) 350-2777

975 S Fairmont Ave
Lodi, CA 95240
Phone (209) 339-7575

1601 Cummins Dr
Ste D
Modesto, CA 95358
Phone (510) 851-7423

5974 Pentz Rd
Paradise, CA 95969
Phone (530) 872-2000

5974 Pentz Rd
#1112
Paradise, CA 95969

1800 N California St
Stockton, CA 95204
Phone (209) 467-6400

525 W Acacia St
Stockton, CA 95203
Phone (209) 944-5410

825 Delbon Ave
Turlock, CA 95382
Phone (209) 664-2744

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Caringhand Home Health Solutions, Inc.Sacramento, CA, CCN 559558 Home health agency 5% Or Greater Direct Ownership Interest (100%)
Corporate Officer (100%)
Corporate Director (100%)
Aug 20, 2020
Aug 20, 2020
Aug 20, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 10

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.

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": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373241600000",
    "number": "1194751537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N TUSTIN AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053807",
            "telephone_number": "714-347-1010",
            "fax_number": "714-647-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 S FAIRMONT AVE",
            "city": "LODI",
            "state": "CA",
            "postal_code": "952405118",
            "telephone_number": "408-500-1186",
            "fax_number": "408-847-1460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAUDER",
        "first_name": "PATRICIO",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-25",
        "last_updated": "2013-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A64160",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A641601",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PATRICIO",
            "last_name": "LAUDER",
            "middle_name": "L",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Lodi, CA

Sources for this page

Verify at the official NPI Registry.