Patricia Allison Tatum, NURSE PRACTITIONER
Individual provider Active NPI Family Medicine Physician · Los Altos Hills, CA
NPI 1194862961 · NPPES record last updated Oct 28, 2024
Key facts
- NPI
- 1194862961
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 650816 (TX)
- Practice address
- 14355 Miranda Way
Los Altos Hills, CA 94022-2032 - Phone
- (888) 731-8994
- NPI assigned
- Jan 31, 2007
- Reactivated
- Oct 28, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 21
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- DCS Medical PA
Practice addresses (Care Compare)
2857 W Washington St
Stephenville, TX 76401-3706
Phone (254) 965-5273
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090617000410 | TX | Practitioner - Nurse Practitioner | 7315097110 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| DCS Medical PA | Current |
Accepting new patients | |
| DCS Medical PA | Current |
Accepting new patients | |
| Allergy & Asthma Care of Waco, PA | Past |
Accepting new patients | |
| Medical Parkway Family Practice,LLP | Family Medicine | Past | Accepting new patients |
| DCS Medical PA | Past | Accepting new patients | |
| GTG Enterprises, LLC | Family Medicine | Past |
Accepting new patients |
Locations
3201 University Dr E
Ste 135
Bryan, TX 77802
Phone (979) 703-1832
2857 W Washington St
Stephenville, TX 76401
Phone (254) 965-5273
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 650816 | TX | |
| Family Medicine Physician | 207Q00000X | 650816 | TX | Yes |
Addresses
Primary practice location
14355 Miranda Way
Los Altos Hills, CA 94022-2032
Mailing address
155 County Road 511
Stephenville, TX 76401-8064
Phone (254) 723-0362
Other providers in Los Altos Hills, CA
- Nicole Shin
- Angel Marie Smith
- Paul Norman Snider
- Jenna Harris Starko
- Edward Brad Stinson
- Saba Torabian
- Catherine Julia Varsanyi
- Sarah Wallis
- Lisa Walton
- Julie A Welsh
All providers in Los Altos Hills, CA · Family Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 28, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.