Individual provider Active NPI

Daniel Yugi Patten, MD

  • Family Medicine Physician
  • Preston, ID
National Provider Identifier
1245490390
Registry record updated Jul 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
M11689 Issued in ID
Practice address
47 N. 1St E.
Preston, ID 83263
Phone
(208) 852-2900
Fax
(208) 852-3511
NPI assigned
Jun 12, 2008
Last updated
Jul 5, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X M11689 ID Primary

Addresses

Primary practice location

47 N. 1St E.
Preston, ID 83263

Mailing address

44 N 1St E
Preston, ID 83263-1326
Phone (208) 852-3662

Other practice location 1

44 N 1st E
Preston, ID 83263-1326
Phone (208) 852-3662

Other identifiers 2

IdentifierTypeStateIssuer
M-11689OtherIDMEDICAL LICENSE
1245490390MedicaidID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ID
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
I20120926000525 ID Practitioner - Family Practice 5597819011 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Louisiana State University School of Medicine in Shreveport, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Franklin County Medical CenterGroup PAC ID 8820909104, 25 clinicians

Practice addresses (Care Compare)

44 N 1St
Preston, ID 83263-1326
Phone (208) 852-0137

64 N 1St
Preston, ID 83263-1326
Phone (208) 852-3662

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M11689IDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franklin County Medical Center Past Accepting new patients
Multicare Health System Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: daniel.patten.1@17373.direct.athenahealth.com

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, 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": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530748800000",
    "number": "1245490390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 N 1ST E",
            "city": "PRESTON",
            "state": "ID",
            "postal_code": "832631326",
            "telephone_number": "208-852-3662",
            "fax_number": "208-852-1295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 N. 1ST E.",
            "city": "PRESTON",
            "state": "ID",
            "postal_code": "83263",
            "telephone_number": "208-852-2900",
            "fax_number": "208-852-3511"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44 N 1st E",
            "address_purpose": "LOCATION",
            "city": "Preston",
            "state": "ID",
            "postal_code": "832631326",
            "country_code": "US",
            "telephone_number": "208-852-3662",
            "fax_number": "208-852-1295",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATTEN",
        "first_name": "DANIEL",
        "middle_name": "YUGI",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-12",
        "last_updated": "2018-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ID",
            "license": "M11689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "M-11689",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1245490390",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Preston, ID

Sources for this page

Verify at the official NPI Registry.