Donald G Patacca, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19111 Issued in OH

Practice address

1600 E Royalton Rd
Broadview Heights, OH 44147-2549

Phone

(440) 546-0330

Fax

(440) 746-1147

NPI assigned

Jun 21, 2005

Reactivated

Apr 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454544000000",
    "number": "1265438626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 E ROYALTON RD",
            "city": "BROADVIEW HEIGHTS",
            "state": "OH",
            "postal_code": "441472549",
            "telephone_number": "440-546-0330",
            "fax_number": "440-746-1147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 E ROYALTON RD",
            "city": "BROADVIEW HEIGHTS",
            "state": "OH",
            "postal_code": "441472549",
            "telephone_number": "440-546-0330",
            "fax_number": "440-746-1147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATACCA",
        "first_name": "DONALD",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-21",
        "last_updated": "2016-02-04",
        "deactivation_date": "2006-03-21",
        "reactivation_date": "2006-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "19111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Osterman, FNP-BC
• Monah Pannell
• Pannette Behavioral Health Care LLC
• Douglas Paul Pannette, LISW-S
• Adrianne Marie Parker, PMHNP-BC
• John Bruce Pate
• Paul Bures DO
• Annette L. Pedersen, RDN, LD, CDE
• Sarah Pennington
• Alyssa Perna

• General Practice Dentistry in Broadview Heights, OH
• Providers in Broadview Heights, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.