Jeffery Bartholomeau Dattilo, M.D.

Primary specialty

Vascular Surgery PhysicianTaxonomy code 2086S0129X

License

36524 Issued in TN

Practice address

4230 Harding Pike Ste 705
Nashville, TN 37205-2013

Phone

(615) 385-1547

Fax

(615) 297-9161

NPI assigned

Dec 6, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TN

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IIJFBA

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.

• The Surgical Clinic PLLC

  • Surgery Physician
  • Nashville, TN
  • NPI 1417983099
  Medicare reassignment NPD
• Jordan Physician Associates, Inc.

  • Anatomic Pathology & Clinical Pathology Physician
  • Plymouth, MA
  • NPI 1194263186
  NPD (past)
• Jordan Physician Associates, Inc.

  • Family Medicine Physician
  • Plymouth, MA
  • NPI 1538145131

  Vascular Surgery

  NPD (past)

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1326022039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 42ND AVE N STE 400",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372093658",
            "telephone_number": "615-329-7887",
            "fax_number": "615-346-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4230 HARDING PIKE STE 705",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372052013",
            "telephone_number": "615-385-1547",
            "fax_number": "615-297-9161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DATTILO",
        "first_name": "JEFFERY",
        "middle_name": "BARTHOLOMEAU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-06",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MA",
            "license": "205177",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "TN",
            "license": "36524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q007288",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shima Daryan
• Rishub Karan Das, MD
• Satya Bikram Das, MD
• Varsha Das
• Lindsay Dassau
• Karishma Abhaya Datye, M.D.
• Danielle Dauchot
• Amanda Daugherty, FNP
• Anna Elizabeth Daugherty, BCBA
• Matthew Daugherty

• Vascular Surgery Physician in Nashville, TN
• Providers in Nashville, TN by specialty
• Vascular Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; 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.