Individual provider Active NPI

Paul Michael Patterson, D.N.P.

  • Family Nurse Practitioner
  • La Plata, MD
National Provider Identifier
1285639617
Registry record updated Dec 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R148876 Issued in MD
Practice address
115A la Grange Ave
Suite 101
La Plata, MD 20646-9597
Phone
(301) 392-1935
Fax
(301) 392-1936
NPI assigned
Jun 13, 2005
Last updated
Dec 12, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X R148876 MD Primary

Addresses

Primary practice location

115A la Grange Ave
Suite 101
La Plata, MD 20646-9597

Mailing address

115A la Grange Ave
Suite 101
La Plata, MD 20646-9597
Phone (301) 392-1935

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050210000924 MD Practitioner - Nurse Practitioner 0446202105 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

115 A la Grange Ave
Suite 101
La Plata, MD 20646-9592

115 A Lagrange Ave
Suite 101
Laplata, MD 20646-9592

115 La Grange Ave
Suite 101a
La Plata, MD 20646-9504
Phone (301) 392-1935

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
P. Michael Patterson Family CurrentSince Mar 9, 2004 Accepting new patients

Locations

115 La Grange Ave
Ste 101
La Plata, MD 20646
Phone (301) 392-1935

404 E Charles St
La Plata, MD 20646
Phone (301) 392-1935

Organizations & group practices 2

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 3

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": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1285639617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115A LA GRANGE AVE",
            "address_2": "SUITE 101",
            "city": "LA PLATA",
            "state": "MD",
            "postal_code": "206469597",
            "telephone_number": "301-392-1935",
            "fax_number": "301-392-1936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115A LA GRANGE AVE",
            "address_2": "SUITE 101",
            "city": "LA PLATA",
            "state": "MD",
            "postal_code": "206469597",
            "telephone_number": "301-392-1935",
            "fax_number": "301-392-1936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "PAUL",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.N.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R148876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Plata, MD

Sources for this page

Verify at the official NPI Registry.