Jeromy Ryan Patterson, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

278937 Issued in NY

Practice address

11602 Queens Blvd Ste a
Forest Hills, NY 11375-7055

Phone

(718) 301-1100

Fax

(718) 261-3893

NPI assigned

Jun 5, 2011

Last updated

Oct 12, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in NY, CT2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

General Surgery

Education

Univ of Rochester School of Dental Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Queens Medical of New York LLCGroup PAC ID 3870748692, 4 clinicians

Bushwick Medical of New York LLCGroup PAC ID 5092068262, 21 clinicians

Pelham Pkwy Professional Medical Services of New York LLCGroup PAC ID 9335404557, 10 clinicians

Fordham Medical of New York LLCGroup PAC ID 4284972621, 24 clinicians

Pelham Pkwy Medical of New York LLCGroup PAC ID 4082976386, 23 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 52)

Networks

• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678
• Healthfirst Medicare Network H3359

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.

• Pelham Pkwy Medical of New York LLC

  • Vascular Surgery Physician
  • Bronx, NY
  • NPI 1285156067
  Medicare reassignment Care Compare group NPD
• Pelham Pkwy Professional Medical Services of New York LLC

  • Vascular Surgery Physician
  • Bronx, NY
  • NPI 1063926962
  Medicare reassignment Care Compare group NPD
• Bushwick Medical of New York LLC

  • Vascular Surgery Physician
  • Brooklyn, NY
  • NPI 1720565922
  Medicare reassignment Care Compare group
• Fordham Medical of New York LLC

  • Vascular Surgery Physician
  • Bronx, NY
  • NPI 1205332905
  Medicare reassignment Care Compare group
• Queens Medical of New York LLC

  • Vascular Surgery Physician
  • Forest Hills, NY
  • NPI 1730439704
  Medicare reassignment Care Compare group
• Astoria Medical of New York, LLC

  • Vascular Surgery Physician
  • Astoria, NY
  • NPI 1790156982
  Medicare reassignment NPD
• Bushwick Professional Medical Services of New York LLC

  • Vascular Surgery Physician
  • Brooklyn, NY
  • NPI 1003393299
  Medicare reassignment NPD
• Corona Medical of New York LLC

  • Vascular Surgery Physician
  • Jackson Heights, NY
  • NPI 1437691920
  Medicare reassignment NPD
• Foxhurst Medical of New York LLC

  • Vascular Surgery Physician
  • Bronx, NY
  • NPI 1730547522
  Medicare reassignment NPD
• Foxhurst Professional Medical Services of New York LLC

  • Vascular Surgery Physician
  • Bronx, NY
  • NPI 1366956260
  Medicare reassignment NPD
• Integrated Wound Care New York Medical PLLC

  • General Practice Physician
  • Tappan, NY
  • NPI 1639649643
  Medicare reassignment NPD
• Jamaica Queens Medical of New York LLC

  • Vascular Surgery Physician
  • Jamaica, NY
  • NPI 1366962961
  Medicare reassignment NPD

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

{
    "created_epoch": "1307232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539302400000",
    "number": "1770877953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6851 JERICHO TPKE STE 150",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117914462",
            "telephone_number": "516-717-1817",
            "fax_number": "631-204-6446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11602 QUEENS BLVD STE A",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113757055",
            "telephone_number": "718-301-1100",
            "fax_number": "718-261-3893"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6851 Jericho Tpke Ste 150",
            "address_purpose": "LOCATION",
            "city": "Syosset",
            "state": "NY",
            "postal_code": "11791",
            "country_code": "US",
            "telephone_number": "516-717-1817",
            "fax_number": "631-204-6446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "JEROMY",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-05",
        "last_updated": "2018-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "278937",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04680333",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NYC SURGICAL ASSOCIATES",
            "identifier": "1720357817",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patelsriramanllp
• Sotiria Pateroulakis, PHARMD.
• Naama Patinkin, LCSW
• Paola Jimena Patino Figueroa
• Ines Lorena Patino Mantilla
• Paul a.C. Greenberg M.D. P.C.
• Paul Aaronson MD, PLLC
• Paul Soren Odpc
• Shiney Paul, NP
• Beth Pearlmutter, OD

• Surgery Physician in Forest Hills, NY
• Providers in Forest Hills, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2018; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.