NPIMap

Individual provider Active NPI

Jerod Patchin, DO

  • Internal Medicine Physician
  • Waco, TX
National Provider Identifier
1386957769
Registry record updated Jan 6, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
P2505 Issued in TX
Practice address
301 Richland West Cir
Waco, TX 76712-7932
Phone
(254) 537-6200
NPI assigned
Jul 14, 2010
Last updated
Jan 6, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 6, 2017

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 P2505 TX Primary

Addresses

Primary practice location

301 Richland West Cir
Waco, TX 76712-7932

Mailing address

PO Box 18962
Belfast, ME 04915-4084
Phone (800) 566-5050

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20130717000176 TX Practitioner - Internal Medicine 5294975124 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of North Texas HSC, College of Osteopathic Med, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Providence Health AllianceGroup PAC ID 6305731068, 119 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

301 Richland W Cir
Providence Internal Medicine Clinic
Waco, TX 76712-7932
Phone (254) 537-6200

5400 Laurel Lake Dr
Waco, TX 76710-2835
Phone (254) 399-6633

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health Alliance CurrentSince Jul 1, 2013 Accepting new patients
Medhealth CurrentSince Oct 1, 2020 Accepting new patients
McLennan County Hospitalist Services PA Internal Medicine CurrentSince Oct 5, 2013 Accepting new patients
Vibra Physicians LLC CurrentSince May 1, 2016 Accepting new patients
Physician Associates of Southwest Dallas Internal Medicine CurrentSince Oct 1, 2015 Accepting new patients
Medhealth Internal Medicine CurrentSince Oct 1, 2020 Accepting new patients
Providence Health Alliance CurrentSince Jul 1, 2013 Accepting new patients

Locations

122 W Colorado Blvd
Dallas, TX 75208
Phone (214) 947-6555

1441 N Beckley Ave
Dallas, TX 75203
Phone (214) 712-2429

2700 Walker Way
Desoto, TX 75115
Phone (972) 283-5284

301 Richland West Cir
Waco, TX 76712
Phone (254) 537-6200

6901 Medical Pkwy
Waco, TX 76712
Phone (254) 751-4000

Interoperability endpoints

  • Direct secure messaging: jerod.patchin.1@9635.direct.athenahealth.com

Organizations & group practices 8

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 8

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": "1279065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483660800000",
    "number": "1386957769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 18962",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154084",
            "telephone_number": "800-566-5050",
            "fax_number": "254-537-6869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 RICHLAND WEST CIR",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127932",
            "telephone_number": "254-537-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATCHIN",
        "first_name": "JEROD",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-14",
        "last_updated": "2017-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "P2505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.