Individual provider Active NPI

Angela Michelle Patteson, OD

  • Optometrist
  • Johnson City, TN
National Provider Identifier
1437112984
Registry record updated Jan 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
2796 Issued in TN
Practice address
302 Sunset Dr
Suite 109
Johnson City, TN 37604-2408
Phone
(423) 282-1742
Fax
(423) 283-4924
NPI assigned
Apr 7, 2006
Last updated
Jan 17, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2796 TN Primary

Addresses

Primary practice location

302 Sunset Dr
Suite 109
Johnson City, TN 37604-2408

Mailing address

302 Sunset Dr
Suite 109
Johnson City, TN 37604-2408
Phone (423) 282-1742

Other identifiers 1

IdentifierTypeStateIssuer
1521262MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111011000263 TN Practitioner - Optometry 6901078229 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Southern College of Optometry, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sunset Eye Care, PCGroup PAC ID 4082846332, 4 clinicians

Practice addresses (Care Compare)

302 Sunset Dr
Suite 109
Johnson City, TN 37604-2408
Phone (423) 282-1742

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2796TNMDMental Health Counselor
1200SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sunset Eye Care PC Optometrist CurrentSince Jan 2, 2014 Accepting new patients
Brookside Vision Center PLLC Optometrist Current Accepting new patients
Dr Richard a Rosenberg, OD Optometrist PastSince Jan 2, 2014 Accepting new patients
Luxottica of America Inc Past Accepting new patients
Family Eye Care and Pediatric Vision Center, PLLC Optometrist PastSince Jun 1, 2008 Accepting new patients

Locations

302 Sunset Dr
Ste 109
Johnson City, TN 37604
Phone (423) 282-1742

Interoperability endpoints

  • Direct secure messaging: apattesonod@sunset-eye-care-pc.direct.kno2fy.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.

NPI Registry JSON

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

{
    "created_epoch": "1144368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1389916800000",
    "number": "1437112984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 SUNSET DR",
            "address_2": "SUITE 109",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042408",
            "telephone_number": "423-282-1742",
            "fax_number": "423-283-4924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 SUNSET DR",
            "address_2": "SUITE 109",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042408",
            "telephone_number": "423-282-1742",
            "fax_number": "423-283-4924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTESON",
        "first_name": "ANGELA",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-07",
        "last_updated": "2014-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TN",
            "license": "2796",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1521262",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.