Individual provider Active NPI

Joseph Michael Patti, RPA-C

  • Physician Assistant
  • East Patchogue, NY
National Provider Identifier
1447593009
Registry record updated Apr 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
016432 Issued in NY
Practice address
100 Hospital Rd
East Patchogue, NY 11772-8809
Phone
(631) 687-4200
NPI assigned
Apr 2, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 2, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 016432 NY Primary

Addresses

Primary practice location

100 Hospital Rd
East Patchogue, NY 11772-8809

Mailing address

72 Masonic Ave
Holtsville, NY 11742-2358
Phone (631) 935-4058

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210921000849 NY Practitioner - Physician Assistant 1052547973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Justin Mirza DO PCGroup PAC ID 5597070680, 2 clinicians

Practice addresses (Care Compare)

290 E Main St
Suite 200
Smithtown, NY 11787-2916
Phone (631) 361-5302

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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": "1364860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364860800000",
    "number": "1447593009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 MASONIC AVE",
            "city": "HOLTSVILLE",
            "state": "NY",
            "postal_code": "117422358",
            "telephone_number": "631-935-4058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL RD",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117728809",
            "telephone_number": "631-687-4200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTI",
        "first_name": "JOSEPH",
        "middle_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "RPA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-02",
        "last_updated": "2013-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "016432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Patchogue, NY

Sources for this page

Verify at the official NPI Registry.