NPIMap

Organization Active NPI

Theta Pattison MD

  • Dermatology Physician
  • Altamont, NY
National Provider Identifier
1942292925
Registry record updated Jan 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
THETA PATTISON MD
Practice address
2508 Western Ave
Altamont, NY 12009-9485
Phone
(518) 690-0177
NPI assigned
Aug 17, 2005
Last updated
Jan 18, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2008

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

Authorized official

Name
Dr. Theta Pattison, MDNPI 1841298510
Title
Owner
Phone
(518) 690-0177

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X Primary

Addresses

Primary practice location

2508 Western Ave
Altamont, NY 12009-9485

Mailing address

PO Box 9312
Theta Pattison MD
Schenectady, NY 12309-0312
Phone (518) 690-0177

Other identifiers 1

IdentifierTypeStateIssuer
02042400OtherNYGROUP MEDICAID

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200614400000",
    "number": "1942292925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9312",
            "address_2": "THETA PATTISON MD",
            "city": "SCHENECTADY",
            "state": "NY",
            "postal_code": "123090312",
            "telephone_number": "518-690-0177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2508 WESTERN AVE",
            "city": "ALTAMONT",
            "state": "NY",
            "postal_code": "120099485",
            "telephone_number": "518-690-0177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THETA PATTISON MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-17",
        "last_updated": "2008-01-18",
        "status": "A",
        "authorized_official_last_name": "PATTISON",
        "authorized_official_first_name": "THETA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "518-690-0177",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICAID",
            "identifier": "02042400",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Altamont, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.