NPIMap

Individual provider Active NPI

Paul Lin Patton, PA-C

  • Surgical Physician Assistant
  • Fairbanks, AK
National Provider Identifier
1437401502
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PADA1214 Issued in AK
Practice address
1211 Cushman St Ste 100
Fairbanks, AK 99701-4680
Phone
(907) 328-0989
NPI assigned
Oct 12, 2012
Last updated
Aug 22, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA60314316 WA
Surgical Physician Assistant 363AS0400X PADA1214 AK Primary

Addresses

Primary practice location

1211 Cushman St Ste 100
Fairbanks, AK 99701-4680

Mailing address

104 Woodmont Blvd Ste 500
Nashville, TN 37205-2245
Phone (907) 276-2803

Other identifiers 2

IdentifierTypeStateIssuer
1626613MedicaidAK
1214OtherAKAK STATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AK
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
I20150804005297 AK Practitioner - Physician Assistant 7517118664 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Fairbanks UrologyGroup PAC ID 6608100425, 4 clinicians

Practice addresses (Care Compare)

1211 Cushman St
Fairbanks, AK 99701-4680
Phone (907) 452-1761

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Alaska Center for Pediatrics, LLC CurrentSince Oct 16, 2019 Accepting new patients
Steese Immediate Care Past Accepting new patients
RBS Evolution of Alaska LLC PastSince Dec 1, 2024 Accepting new patients

Locations

3801 University Lake Dr
Ste 301
Anchorage, AK 99508
Phone (907) 777-1850

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9493/brand/2/csg/1/fhir/r4
  • Direct secure messaging: paul.patton.1@31576.direct.athenahealth.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.

Hospital & facility affiliations 2

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": "1350000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1437401502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 WOODMONT BLVD STE 500",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372052245",
            "telephone_number": "907-276-2803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 CUSHMAN ST STE 100",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997014680",
            "telephone_number": "907-328-0989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTON",
        "first_name": "PAUL",
        "middle_name": "LIN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-12",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA60314316",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "AK",
            "license": "PADA1214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1626613",
            "state": "AK"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AK STATE LICENSE",
            "identifier": "1214",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

Verify at the official NPI Registry.