Individual provider Active NPI

Debra C Pattison, O.D.

  • Optometrist
  • Roseville, CA
National Provider Identifier
1760485429
Registry record updated May 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
10653 Issued in CA
Practice address
215 Vernon St
Roseville, CA 95678-2632
Phone
(916) 783-8144
Fax
(916) 783-8179
NPI assigned
May 24, 2005
Last updated
May 21, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 10653 CA Primary

Addresses

Primary practice location

215 Vernon St
Roseville, CA 95678-2632

Mailing address

215 Vernon St
Roseville, CA 95678-2632
Phone (916) 783-8144

Other identifiers 2

IdentifierTypeStateIssuer
410030767OtherCARAILROAD MEDICARE
SD0106530MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060426000492 CA Practitioner - Optometry 7214947977 Reassigns benefits to 1 organization
Receives reassigned benefits from 1 practitioner
Practice locations: Roseville, CA
O20100930048889 CA DME Supplier - Physician - Optometrist 3375664386 Practice locations: Roseville, CA

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
New England College of Optometry, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

215 Vernon St
Roseville, CA 95678-2632
Phone (916) 783-8144

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery26

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10653CAMDOptometrist

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716249600000",
    "number": "1760485429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 VERNON ST",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956782632",
            "telephone_number": "916-783-8144",
            "fax_number": "916-783-8179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 VERNON ST",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "956782632",
            "telephone_number": "916-783-8144",
            "fax_number": "916-783-8179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTISON",
        "first_name": "DEBRA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-05-24",
        "last_updated": "2024-05-21",
        "certification_date": "2024-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "10653",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "410030767",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SD0106530",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, CA

Sources for this page

Verify at the official NPI Registry.