Active NPI
Douglas R. Patten, O.D.
- Optometrist
- Oakdale, CA
National Provider Identifier
1952360182
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 6600T
- Practice address
- 136 N Maag Ave
Ste D
Oakdale, CA 95361-2250 - Phone
- (209) 847-1121
- NPI assigned
- Mar 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 6600T | CA | Primary |
| Optometrist | 152W00000X | ODP-594 | ID |
Addresses
Primary practice location
136 N Maag Ave
Ste D
Oakdale, CA 95361-2250
Mailing address
136 N Maag Ave
Ste D
Oakdale, CA 95361-2250
Phone (209) 847-1121
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6600T | CA | MD | Optometrist |
| ODP-594 | ID | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1381190400000",
"number": "1952360182",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "136 N MAAG AVE",
"address_2": "STE D",
"city": "OAKDALE",
"state": "CA",
"postal_code": "953612250",
"telephone_number": "209-847-1121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "136 N MAAG AVE",
"address_2": "STE D",
"city": "OAKDALE",
"state": "CA",
"postal_code": "953612250",
"telephone_number": "209-847-1121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATTEN",
"first_name": "DOUGLAS",
"middle_name": "R.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-17",
"last_updated": "2013-10-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "6600T",
"primary": true
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "ID",
"license": "ODP-594",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oakdale, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2013; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.