Individual provider Active NPI

Tina Patterson, PA

  • Physician Assistant
  • Des Moines, IA
National Provider Identifier
1518977313
Registry record updated Jan 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
00822 Issued in IA
Practice address
6601 SW 9TH St
Des Moines, IA 50315-6138
Phone
(515) 643-9400
Fax
(515) 643-9405
NPI assigned
Aug 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 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 00822 IA Primary

Addresses

Primary practice location

6601 SW 9TH St
Des Moines, IA 50315-6138

Mailing address

PO Box 1475
Des Moines, IA 50305-1475
Phone (515) 643-9400

Other names 1

  • Tina Brightwell Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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
I20100512000909 IA Practitioner - Physician Assistant 4082742085 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Clinics IncGroup PAC ID 7911810882, 441 clinicians

Practice addresses (Care Compare)

2006 N 4TH St
Indianola, IA 50125-4500

2605 SW White Birch Dr
Mercyone Ankeny Prairie Trail Family Medici
Ankeny, IA 50023-7235
Phone (515) 643-7100

2605 SW White Birch Dr
Mercyone S Des Moines Behavioral Health Car
Ankeny, IA 50023-7204
Phone (515) 643-8350

4003 NW Urbandale Dr
Mercyone Geriatrics Care
Urbandale, IA 50322-7914
Phone (515) 237-3985

4005 NW Urbandale Dr
Urbandale, IA 50322-7914

6601 SW 9TH St
Des Moines, IA 50315-6138

800 E 1St St
Ankeny, IA 50021-2077

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Clinics, Inc. CurrentSince Dec 1, 2000 Accepting new patients
Boone County Hospital Past Accepting new patients

Locations

6601 SW 9th St
Des Moines, IA 50315
Phone (515) 643-9400

6601 SW 9th St
Ste 2
Des Moines, IA 50315

405 SW 5th St
Ste E
Des Moines, IA 50309
Phone (515) 358-7259

Interoperability endpoints

  • Direct secure messaging: tpatterson3954200@direct.trinity-health.org

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.

Hospital & facility affiliations 4

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": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357084800000",
    "number": "1518977313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1475",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503051475",
            "telephone_number": "515-643-9400",
            "fax_number": "515-643-9405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6601 SW 9TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503156138",
            "telephone_number": "515-643-9400",
            "fax_number": "515-643-9405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "TINA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-08",
        "last_updated": "2013-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "00822",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TINA",
            "last_name": "BRIGHTWELL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.