Individual provider Active NPI

Patricia Coquillon, M.D.

  • Emergency Medicine Physician
  • Brooklyn, NY
National Provider Identifier
1386956357
Registry record updated Sep 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
Q1383 Issued in TX
Practice address
800 Poly Place
VA Ny Harbor Healthcare System
Brooklyn, NY 11209
Phone
(718) 836-6600
NPI assigned
Jul 7, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Q1383 TX Primary

Addresses

Primary practice location

800 Poly Place
VA Ny Harbor Healthcare System
Brooklyn, NY 11209

Mailing address

214 Macdougal St
Apt C2
Brooklyn, NY 11233-2750
Phone (516) 512-1740

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20200413000546 GA Practitioner - Emergency Medicine 0446470637 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Bortolazzo Group, LLC Emergency Medicine CurrentSince Oct 30, 2019 Accepting new patients
The Southeast Permanente Medical Group CurrentSince Jul 10, 2023 Accepting new patients
Peachtree Immediate Care FP, LLC CurrentSince Feb 1, 2024 Accepting new patients
St Joseph Emergency Physicians PLLC Emergency Medicine Current Accepting new patients
Texas Em-1 Medical Services PA Emergency Medicine Past Accepting new patients
Singleton Associates PA Past Accepting new patients

Locations

3495 Piedmont Rd NE
Bldg 9
Atlanta, GA 30305
Phone (404) 364-7000

3950 Austell Rd
Austell, GA 30106
Phone (770) 732-3752

590 Lanier Ave W
Fayetteville, GA 30214

1275 Highway 54 W
Ste 201
Fayetteville, GA 30214
Phone (770) 461-3776

3827 Jimmy Lee Smith Pkwy
Hiram, GA 30141
Phone (770) 222-8900

1401 St Joseph Pkwy
Houston, TX 77002
Phone (713) 575-1000

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/14272/brand/70/csg/1/fhir/r4

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1278460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410739200000",
    "number": "1386956357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 MACDOUGAL ST",
            "address_2": "APT C2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112332750",
            "telephone_number": "516-512-1740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 POLY PLACE",
            "address_2": "VA NY HARBOR HEALTHCARE SYSTEM",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11209",
            "telephone_number": "718-836-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COQUILLON",
        "first_name": "PATRICIA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-07",
        "last_updated": "2014-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "Q1383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.