NPIMap

Individual provider Active NPI

Denne Michelle Thomas-Patterson, MD

  • Family Medicine Physician
  • Media, PA
National Provider Identifier
1386797603
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD72726L Issued in PA
Practice address
176 S New Middletown Rd
Media, PA 19063-5255
Phone
(610) 627-3690
Fax
(610) 627-3684
NPI assigned
Jan 19, 2007
Last updated
Oct 19, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD72726L PA Primary

Addresses

Primary practice location

176 S New Middletown Rd
Media, PA 19063-5255

Mailing address

219 N Ulmer Ave
Gibbstown, NJ 08027-1150
Phone (856) 224-1917

Other identifiers 1

IdentifierTypeStateIssuer
001860910MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dthomaspatterson14158@directvirtua.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20150522000801 NJ Practitioner - Family Practice 5698968980 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Brody School of Medicine at East Carolina University, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Virtua Medical Group, PAGroup PAC ID 9830222397, 1,678 clinicians

Practice addresses (Care Compare)

1000 Atlantic Ave
Camden, NJ 08104-1132

3242 Route 206
Bordentown, NJ 08505-4517

6981 N Park Dr
Pennsauken, NJ 08109-4201

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD72726LPAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Virtua Medical Group, PA Family Medicine Current Accepting new patients
Virtua Medical Group, PA CurrentSince Mar 25, 2015 Accepting new patients
Virtua Our Lady of Lourdes Hospital Inc Past Accepting new patients
Kennedy University Hospital Inc. Past Accepting new patients
Virtua - West Jersey Health System, Inc. Past Accepting new patients
The Cooper Health System Past Accepting new patients

Locations

3242 Route 206
Ste 2
Bordentown, NJ 08505
Phone (609) 298-4340

141 Route 70 E
Ste E
Marlton, NJ 08053
Phone (856) 985-7373

303 Lippincott Dr
Marlton, NJ 08053

Interoperability endpoints

  • Direct secure messaging: dthomaspatterson14158@directvirtua.org

Organizations & group practices 6

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 4

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": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1386797603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 N ULMER AVE",
            "city": "GIBBSTOWN",
            "state": "NJ",
            "postal_code": "080271150",
            "telephone_number": "856-224-1917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 S NEW MIDDLETOWN RD",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635255",
            "telephone_number": "610-627-3690",
            "fax_number": "610-627-3684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS-PATTERSON",
        "first_name": "DENNE",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-19",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD72726L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001860910",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dthomaspatterson14158@directvirtua.org",
            "affiliation": "N",
            "address_1": "176 S New Middletown Rd",
            "city": "Media",
            "state": "PA",
            "country_code": "US",
            "postal_code": "190635255",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.