Individual provider Active NPI

Thomas Stevenson Pattison, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Davis, CA
National Provider Identifier
1306921580
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
G72662 Issued in CA
Practice address
260 Russell Blvd.
Suite D-4
Davis, CA 95616
Phone
(916) 456-2220
Fax
(916) 456-2223
NPI assigned
Oct 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X G72662 CA Primary

Addresses

Primary practice location

260 Russell Blvd.
Suite D-4
Davis, CA 95616

Mailing address

PO Box 1079
Davis, CA 95617
Phone (916) 456-2220

Other identifiers 2

IdentifierTypeStateIssuer
2610834OtherCAMEDICAL PIN #
68-0435381OtherCATAX ID#

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20080424000406 CA Practitioner - Physical Medicine and Rehabilitation 5395823819 Practice locations: Sacramento, CA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
G72662CAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sutter North Medical Foundation PastSince Dec 31, 2023 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736812800000",
    "number": "1306921580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1079",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "95617",
            "telephone_number": "916-456-2220",
            "fax_number": "916-456-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 RUSSELL BLVD.",
            "address_2": "SUITE D-4",
            "city": "DAVIS",
            "state": "CA",
            "postal_code": "95616",
            "telephone_number": "916-456-2220",
            "fax_number": "916-456-2223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTISON",
        "first_name": "THOMAS",
        "middle_name": "STEVENSON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-26",
        "last_updated": "2025-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "CA",
            "license": "G72662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL PIN #",
            "identifier": "2610834",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID#",
            "identifier": "68-0435381",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davis, CA

Sources for this page

Verify at the official NPI Registry.