Patrick Patti, MLS, LAT, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

003972 Issued in NY

Practice address

100 Nicolls Rd
Stony Brook, NY 11794-2202

Phone

(631) 632-7583

NPI assigned

Mar 14, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1457913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607126400000",
    "number": "1508227984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 DAVIDSON AVE",
            "city": "RAMSEY",
            "state": "NJ",
            "postal_code": "074461004",
            "telephone_number": "201-921-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 NICOLLS RD",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117942202",
            "telephone_number": "631-632-7583"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1532 W Clybourn St",
            "address_2": "Marquette Athletics",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532332202",
            "country_code": "US",
            "telephone_number": "414-288-5395",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATTI",
        "first_name": "PATRICK",
        "credential": "MLS, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-14",
        "last_updated": "2020-12-05",
        "certification_date": "2020-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WI",
            "license": "1522",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "NY",
            "license": "003972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vishal Kirankumar Patel, MD
• Yash Arvind Patel
• Shivany Pathania, MD
• Arani Dabbiru Patnaik, M.D.
• Kaustav Patra, MD
• David B Paul, MD
• Keisha Shavon Paul, DNP, CNM, MS
• Jacqueline Grace Paveling, NP
• Peace of Mind Acupuncture PC
• Margaret Ophelia Pearce, MD

• Athletic Trainer in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Athletic Trainer in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.