Individual provider Active NPI

Frederick A Patterson, MD

  • Neurology Physician
  • Philadelphia, PA
National Provider Identifier
1871516880
Registry record updated Jan 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
25MA10912300 Issued in NJ
Practice address
3900 Woodland Ave
Philadelphia, PA 19104-4551
Phone
(215) 823-5800
Fax
(757) 534-5395
NPI assigned
Jul 25, 2006
Last updated
Jan 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 25MA10912300 NJ Primary

Addresses

Primary practice location

3900 Woodland Ave
Philadelphia, PA 19104-4551

Mailing address

3900 Woodland Ave
Philadelphia, PA 19104-4551
Phone (215) 823-5800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20170215002003 NY Practitioner - Neurology 4183727639 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA10912300NJMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians of University Hospital, PC CurrentSince Jan 8, 2018 Accepting new patients
North Shore-Lij Medical PC CurrentSince May 1, 2019 Accepting new patients
Physicians of University Hospital, PC CurrentSince Jan 8, 2018 Accepting new patients

Locations

300 Community Dr
Manhasset, NY 11030

1 Edgewater St
Fl 6
Staten Island, NY 10305
Phone (718) 226-1047

1110 South Ave
Ste 305
Staten Island, NY 10314
Phone (718) 226-4645

242 Mason Ave
Staten Island, NY 10305
Phone (718) 226-1458

401 Seaview Ave
Lowr
Staten Island, NY 10305
Phone (718) 226-6186

475 Seaview Ave
Staten Island, NY 10305
Phone (718) 226-8855

4771 Hylan Blvd
Staten Island, NY 10312
Phone (718) 948-8200

501 Seaview Ave
Staten Island, NY 10305
Phone (718) 667-4700

972 Brush Hollow Rd
Westbury, NY 11590

Interoperability endpoints

  • Direct secure messaging: frederickpatterson@nslijmedgr.allscriptsdirect.net

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, 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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706140800000",
    "number": "1871516880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 WOODLAND AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044551",
            "telephone_number": "215-823-5800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 WOODLAND AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044551",
            "telephone_number": "215-823-5800",
            "fax_number": "757-534-5395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "FREDERICK",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2024-01-25",
        "certification_date": "2024-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NJ",
            "license": "25MA10912300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.