Active NPI
Thomas Joseph Patota, LICSW
- Clinical Social Worker
- Odenton, MD
National Provider Identifier
1306878376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 16733
- Practice address
- 1413 Annapolis Road
Suite #207
Odenton, MD 21113 - Phone
- (774) 202-5121
- Fax
- (301) 593-6648
- NPI assigned
- Jul 7, 2006
- Last updated
- Mar 6, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 16733 | MD | Primary |
| Clinical Social Worker | 1041C0700X | 1017034 | MA |
Addresses
Primary practice location
1413 Annapolis Road
Suite #207
Odenton, MD 21113
Mailing address
1413 Annapolis Road
Suite #207
Odenton, MD 21113
Phone (301) 593-8111
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1892215 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1017034 | MA | MD | Clinical Social Worker |
| 16733 | MD | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| South County Psychiatry LLC | Clinical | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152230400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583452800000",
"number": "1306878376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1413 ANNAPOLIS ROAD",
"address_2": "SUITE #207",
"city": "ODENTON",
"state": "MD",
"postal_code": "21113",
"telephone_number": "301-593-8111",
"fax_number": "301-593-6648"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1413 ANNAPOLIS ROAD",
"address_2": "SUITE #207",
"city": "ODENTON",
"state": "MD",
"postal_code": "21113",
"telephone_number": "774-202-5121",
"fax_number": "301-593-6648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATOTA",
"first_name": "THOMAS",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"credential": "LICSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-07",
"last_updated": "2020-03-06",
"certification_date": "2020-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MD",
"license": "16733",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "1017034",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1892215",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Odenton, MD
- Sun Kun Park, DMD
- Raegan Maikel Parker
- Tracy Mitchell Parker, CCC-SLP
- Patient First Maryland Medical Group (Patient First Odenton)
- Patient First Maryland Medical Group PLLC (Patient First - Odenton)
- Scott Anthony Peck, PSYD
- Pediatric Hospital Dentistry
- Christine Peed
- Pellerin Chiropractic, Inc.
- Melissa Pena
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.