Active NPI
Thomas S Patterson, M.D.
- Pediatrics Physician
- Boise, ID
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- M7458
- Practice address
- 777 N Raymond St
Boise, ID 83704-9251 - Phone
- (208) 514-2500
- Fax
- (208) 375-2217
- NPI assigned
- Oct 21, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | M7458 | ID | Primary |
Addresses
Primary practice location
777 N Raymond St
Boise, ID 83704-9251
Mailing address
777 N Raymond St
Boise, ID 83704-9251
Phone (208) 514-2500
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 805185100 | Medicaid | ID | |
| 000010034815 | Other | ID | BLUE SHIELD |
| 45187 | Other | ID | BLUE CROSS |
| 370014214 | Other | ID | RAILROAD MEDICARE |
| 806353600 | Other | ID | HEALTHY CONNECTIONS |
| 000010004870 | Other | ID | BLUE SHIELD |
| DM743 | Other | ID | BLUE CROSS |
| 1467442467 | Medicaid | ID |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ID
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| M7458 | ID | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Full Circle Health, Inc. | Current | Accepting new patients | |
| Full Circle Health, Inc. | Past | Accepting new patients | |
| Saltzer Medical Group, PA | Pediatrics | Past | Accepting new patients |
Locations
8610 W Overland Rd
Boise, ID 83709
Phone (208) 514-2500
6565 W Emerald St
Boise, ID 83704
Phone (208) 377-5055
325 W Idaho St
Boise, ID 83702
Phone (208) 514-2525
777 N Raymond St
Boise, ID 83704
Phone (208) 367-6030
2275 S Eagle Rd
Ste 120
Meridian, ID 83642
Phone (208) 514-2520
215 E Hawaii Ave
Nampa, ID 83686
Phone (208) 463-3234
9850 W St Lukes Dr
Ste 329
Nampa, ID 83687
Phone (208) 331-1155
215 E Hawaii Ave
Ste 140
Nampa, ID 83686
Phone (208) 514-2529
Interoperability endpoints
- tpatterson295129@direct.ochin.org
- https://fhir4.healow.com/fhir/r4/ADHBAA
Organizations & group practices 3
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.
-
- Federally Qualified Health Center (FQHC)
- Boise, ID
- NPI 1841490075
-
- Community/Retail Pharmacy
- Nampa, ID
- NPI 1669125548
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1129852800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1471219200000",
"number": "1467442467",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "777 N RAYMOND ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837049251",
"telephone_number": "208-514-2500",
"fax_number": "208-375-2217"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "777 N RAYMOND ST",
"city": "BOISE",
"state": "ID",
"postal_code": "837049251",
"telephone_number": "208-514-2500",
"fax_number": "208-375-2217"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATTERSON",
"first_name": "THOMAS",
"middle_name": "S",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-10-21",
"last_updated": "2016-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "ID",
"license": "M7458",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "805185100",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "000010034815",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "45187",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "370014214",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHY CONNECTIONS",
"identifier": "806353600",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "000010004870",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "DM743",
"state": "ID"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1467442467",
"state": "ID"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.