Active NPI
Michael J Pattillo, MD
- Internal Medicine Physician
- Richland, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- MD00041086
- Practice address
- 945 Goethals Dr Ste 300
Richland, WA 99352-3552 - Phone
- (509) 943-3196
- Fax
- (509) 946-0455
- NPI assigned
- Aug 25, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD00041086 | WA | |
| Internal Medicine Physician | 207R00000X | MD00041086 | WA | Primary |
Addresses
Primary practice location
945 Goethals Dr Ste 300
Richland, WA 99352-3552
Mailing address
550 Gage Blvd Ste 101
Richland, WA 99352-9532
Phone (509) 946-4611
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 159331 | Other | WA | LABOR & INDUSTRY |
| 8314833 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Internal Medicine
- Education
- Saint Louis University School of Medicine, 1994
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Select Outpatient Services Inc
Practice addresses (Care Compare)
2600 Compass Rd
Glenview, IL 60026-8001
888 Swift Blvd
Richland, WA 99352-3514
Phone (509) 946-4611
Hospital & facility affiliations
- Tri-Cities Home Health
- Kadlec Regional Medical Center
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 12 |
| Removal or shaving of skin growth | 1-10 |
| Skin biopsy | 1-10 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD00041086 | WA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kadlec Regional Medical Center | Internal Medicine | Current | Accepting new patients |
| Kadlec Regional Medical Center | Current | Accepting new patients | |
| Three Rivers Urgent Care LLC | Current | Accepting new patients | |
| Kadlec Regional Medical Center | Current | Accepting new patients |
Locations
1135 Jadwin Ave
Richland, WA 99352
Phone (509) 942-3300
550 Gage Blvd
Ste 101
Richland, WA 99352
945 Goethals Dr
Ste 300
Richland, WA 99352
Phone (509) 943-3196
888 Swift Blvd
Richland, WA 99352
Phone (509) 942-2115
1507 Bombing Range Rd
#A
West Richland, WA 99353
Phone (509) 396-0803
Interoperability endpoints
- michael.pattillo@trfm.eclinicaldirectplus.com
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.
-
- General Acute Care Hospital
- Richland, WA
- NPI 1972507580
Internal Medicine
-
- Urgent Care Clinic/Center
- West Richland, WA
- NPI 1255051389
-
- Rehabilitation Clinic/Center
- Glenview, IL
- NPI 1346368248
-
- Clinic/Center
- Kennewick, WA
- NPI 1063967933
-
- Rehabilitation Hospital Unit
- Richland, WA
- NPI 1790319580
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Richland, WA
- NPI 1972507580
-
- Home Health Agency
- Kennewick, WA
- NPI 1679547244
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716336000000",
"number": "1992798805",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "550 GAGE BLVD STE 101",
"city": "RICHLAND",
"state": "WA",
"postal_code": "993529532",
"telephone_number": "509-946-4611",
"fax_number": "509-627-2983"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "945 GOETHALS DR STE 300",
"city": "RICHLAND",
"state": "WA",
"postal_code": "993523552",
"telephone_number": "509-943-3196",
"fax_number": "509-946-0455"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PATTILLO",
"first_name": "MICHAEL",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-25",
"last_updated": "2024-05-22",
"certification_date": "2023-04-19",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "WA",
"license": "MD00041086",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "WA",
"license": "MD00041086",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LABOR & INDUSTRY",
"identifier": "159331",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8314833",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Richland, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; 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.