Individual provider Active NPI

Patricia Ann Pati, PHD

  • Clinical Psychologist
  • Burlington, VT
National Provider Identifier
1700953312
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
048-0000716 Issued in VT
Practice address
300 Flynn Ave
Burlington, VT 05401-5301
Phone
(802) 658-0400
Fax
(802) 660-3665
NPI assigned
Nov 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 048-0000716 VT Primary

Addresses

Primary practice location

300 Flynn Ave
Burlington, VT 05401-5301

Mailing address

300 Flynn Ave
Burlington, VT 05401-5301
Phone (802) 658-0400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070706000080 VT Practitioner - Clinical Psychologist 9537269410 Practice locations: Williston, VT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

4185 St George Rd
Williston, VT 05495-7695
Phone (802) 651-7737

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
048-0000716VTMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700953312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 FLYNN AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054015301",
            "telephone_number": "802-658-0400",
            "fax_number": "802-660-3665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 FLYNN AVE",
            "city": "BURLINGTON",
            "state": "VT",
            "postal_code": "054015301",
            "telephone_number": "802-658-0400",
            "fax_number": "802-660-3665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATI",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VT",
            "license": "048-0000716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, VT

Sources for this page

Verify at the official NPI Registry.