Individual provider Active NPI

Nicholas Stadis Patniyot, M.D.

  • Psychiatry Physician
  • Chicago, IL
National Provider Identifier
1962667105
Registry record updated Mar 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
N3981 Issued in TX
Practice address
5841 S Maryland Ave
MC 3077
Chicago, IL 60637-1447
Phone
(773) 702-1544
NPI assigned
Jul 28, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 25, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X N3981 TX Primary

Addresses

Primary practice location

5841 S Maryland Ave
MC 3077
Chicago, IL 60637-1447

Mailing address

12978 Trail Hollow Dr
Houston, TX 77079-3708
Phone (832) 269-6405

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20091103000280 TX Practitioner - PsychiatryPractitioner - Geriatric Psychiatry 1355489840 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
PsychiatryAlso: Geriatric Psychiatry
Education
University of Texas Southwestern Medical School at Dallas, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health and Human Services CommissionGroup PAC ID 2163795824, 138 clinicians

Practice addresses (Care Compare)

805 N Dickinson Dr
Rusk State Hospital
Rusk, TX 75785-1006
Phone (903) 683-3421

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Health and Human Services Commission Psychiatry Current Accepting new patients
Ut Physicians CurrentSince Mar 1, 2012 Accepting new patients
Health and Human Services Commission Psychiatry CurrentSince Oct 8, 2019 Accepting new patients
Health and Human Services Commission CurrentSince Oct 8, 2019 Accepting new patients
Ut Physicians Psychiatry CurrentSince Mar 1, 2012 Accepting new patients

Locations

6410 Fannin St
Ste 500
Houston, TX 77030
Phone (713) 500-5714

1941 East Rd
Houston, TX 77054
Phone (713) 486-2500

805 N Dickinson Dr
Rusk, TX 75785
Phone (903) 683-7201

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1217203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427241600000",
    "number": "1962667105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12978 TRAIL HOLLOW DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770793708",
            "telephone_number": "832-269-6405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 S MARYLAND AVE",
            "address_2": "MC 3077",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606371447",
            "telephone_number": "773-702-1544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATNIYOT",
        "first_name": "NICHOLAS",
        "middle_name": "STADIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-28",
        "last_updated": "2015-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "N3981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.