NPIMap

Individual provider Active NPI

Nicholas A Patellis, M.D.

  • Internal Medicine Physician
  • Madison, AL
National Provider Identifier
1366582835
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD.30132 Issued in AL
Practice address
382 Slaughter Rd
Madison, AL 35758-2008
Phone
(256) 428-1096
Fax
(256) 428-1098
NPI assigned
Feb 7, 2007
Last updated
Aug 22, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD.30132 AL Primary

Addresses

Primary practice location

382 Slaughter Rd
Madison, AL 35758-2008

Mailing address

601 S Harbour Island Blvd Ste 200
Tampa, FL 33602-5925
Phone (800) 480-5243

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100621000383 AL Practitioner - Internal Medicine 3274694864 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Rutgers New Jersey Medical School, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
National Family Medical Associates of Alabama, LLCGroup PAC ID 2163879776, 18 clinicians

Practice addresses (Care Compare)

382 Slaughter Rd
Madison, AL 35758-2008
Phone (256) 428-1096

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Tennessee Valley Internal Medicine, PC Internal Medicine CurrentSince Feb 1, 2012 Accepting new patients
National Family Medical Associates, LLC Internal Medicine CurrentSince Aug 1, 2023 Accepting new patients
National Family Medical Associates of Alabama, LLC CurrentSince Nov 1, 2023 Accepting new patients
Madison Medical and Sports Rehabilitation L.L.C Past Accepting new patients

Locations

1304 13th Ave SE
Decatur, AL 35601
Phone (256) 355-9711

3809 Sullivan St
Ste 7
Madison, AL 35758
Phone (256) 428-1096

382 Slaughter Rd
Madison, AL 35758
Phone (256) 428-1096

3942 Government Blvd
Mobile, AL 36693
Phone (251) 460-1103

601 S Harbour Island Blvd
Ste 200
Tampa, FL 33602
Phone (727) 322-3439

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12253/brand/1/csg/1/fhir/r4
  • Direct secure messaging: nicholas.patellis@vt.eclinicaldirectplus.com

Organizations & group practices 5

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 7

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": "1170806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1366582835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S HARBOUR ISLAND BLVD STE 200",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "336025925",
            "telephone_number": "800-480-5243",
            "fax_number": "800-928-7449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "382 SLAUGHTER RD",
            "city": "MADISON",
            "state": "AL",
            "postal_code": "357582008",
            "telephone_number": "256-428-1096",
            "fax_number": "256-428-1098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATELLIS",
        "first_name": "NICHOLAS",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-07",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "MD.30132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, AL

Sources for this page

Verify at the official NPI Registry.