NPIMap

Individual provider Active NPI

Mark George Patterson, D.O.

  • Student in an Organized Health Care Education/Training Program
  • Monroe, WI
National Provider Identifier
1396105631
Registry record updated Dec 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
515 22ND Ave
Monroe, WI 53566-1569
Phone
(608) 324-1518
NPI assigned
Feb 29, 2016
Last updated
Dec 23, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

515 22ND Ave
Monroe, WI 53566-1569

Mailing address

5251 Boulder Dr
Apt. C
West Des Moines, IA 50265-7821
Phone (815) 245-9020

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://webproxyprd.monroeclinic.org/FHIR-PRD/api/FHIR/DSTU2/ Other
Direct Messaging Address mpatterson6773@direct.monroeclinic.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20180613000117 WI Practitioner - HospitalistPractitioner - Internal MedicinePractitioner - Family Practice 1658655782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Monroe Clinic, Inc.Group PAC ID 3072425495, 199 clinicians

Practice addresses (Care Compare)

515 22ND Ave
Monroe, WI 53566-1569
Phone (608) 324-2000

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The Monroe Clinic, Inc. CurrentSince May 8, 2018 Accepting new patients
The Monroe Clinic, Inc. CurrentSince May 8, 2018 Accepting new patients

Locations

700 Carolan Dr
Albany, WI 53502
Phone (608) 862-1616

100 W 8th St
Monroe, WI 53566
Phone (608) 324-1940

2009 5th St
Monroe, WI 53566
Phone (608) 324-1454

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

Interoperability endpoints

  • Direct secure messaging: mpatterson407966@direct-ehr-ssmhc.com
  • Direct secure messaging: mpatterson6773@direct.monroeclinic.org

Organizations & group practices 2

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 5

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": "1456704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1396105631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5251 BOULDER DR",
            "address_2": "APT. C",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502657821",
            "telephone_number": "815-245-9020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 22ND AVE",
            "city": "MONROE",
            "state": "WI",
            "postal_code": "535661569",
            "telephone_number": "608-324-1518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "MARK",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-29",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://webproxyprd.monroeclinic.org/FHIR-PRD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "515 22nd Ave",
            "city": "Monroe",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535661569",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpatterson6773@direct.monroeclinic.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mpatterson6773@direct.monroeclinic.org",
            "address_1": "515 22nd Ave",
            "city": "Monroe",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535661569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Monroe, WI

Sources for this page

Verify at the official NPI Registry.