Individual provider Active NPI

Larry T Patterson, M.D.

  • Pediatric Nephrology Physician
  • Gainesville, FL
National Provider Identifier
1225060908
Registry record updated Jul 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nephrology PhysicianTaxonomy code 2080P0210X
License
ME135748 Issued in FL
Practice address
1600 SW Archer Rd # 100296
Gainesville, FL 32610
Phone
(330) 543-8950
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nephrology Physician 2080P0210X 35.054631 OH
Pediatric Nephrology Physician 2080P0210X ME135748 FL Primary

Addresses

Primary practice location

1600 SW Archer Rd # 100296
Gainesville, FL 32610

Mailing address

1600 SW Archer Rd # 100296
Gainesville, FL 32610-3003

Other identifiers 1

IdentifierTypeStateIssuer
025188400MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20180810002332 FL Practitioner - Pediatric Medicine 7012182165 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
47.54 of 100Reported as apm
Quality
38.49
Promoting interoperability
0
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME135748FLMDPediatric Nephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince Jul 1, 2018 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince Jul 1, 2018 Accepting new patients
Florida Clinical Practice Association Inc Past Accepting new patients

Locations

1600 SW Archer Rd
#100296
Gainesville, FL 32610
Phone (352) 273-7770

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

1549 Gale Lemerand Dr
Gainesville, FL 32610
Phone (352) 265-0496

1600 SW Archer Rd
#100371
Gainesville, FL 32610
Phone (352) 265-8335

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1225060908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD # 100296",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326103003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD # 100296",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "32610",
            "telephone_number": "330-543-8950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "LARRY",
        "middle_name": "T",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "OH",
            "license": "35.054631",
            "primary": false
        },
        {
            "code": "2080P0210X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Nephrology",
            "state": "FL",
            "license": "ME135748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "025188400",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, FL

Sources for this page

Verify at the official NPI Registry.