| Peter Douglas Van Patten, | |
|
1101 9th St N, Virginia, MN 55792-2329 | |
| (218) 741-0150 | |
| Not Available |
| Full Name | Peter Douglas Van Patten |
|---|---|
| Gender | Male |
| Speciality | Ophthalmology |
| Experience | 42 Years |
| Location | 1101 9th St N, Virginia, Minnesota |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720006885 | NPI | - | NPPES |
| 150257300 | Medicaid | MN | |
| 396319500 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207T00000X | Neurological Surgery | 38758 (Minnesota) | Secondary |
| 207W00000X | Ophthalmology | 38758 (Minnesota) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Essentia Health Virginia | Virginia, MN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| The Duluth Clinic Ltd | 2567374283 | 957 |
| Entity Name | The Duluth Clinic Ltd |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1902563638 PECOS PAC ID: 2567374283 Enrollment ID: O20031103000229 |
| Entity Name | Northern Pines Medical Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1639278609 PECOS PAC ID: 3870565641 Enrollment ID: O20040811000988 |
| Mailing Address | Practice Location Address |
|---|---|
| Peter Douglas Van Patten, 1101 9th St N, Virginia, MN 55792-2329 Ph: (218) 741-0150 | Peter Douglas Van Patten, 1101 9th St N, Virginia, MN 55792-2329 Ph: (218) 741-0150 |
Salma Habib Jamal, Ophthalmology Medicare: Not Enrolled in Medicare Practice Location: 1101 9th St N, Virginia, MN 55792 Phone: 218-741-0150 | |
Dr. Bridget Ann Sundell, MD Ophthalmology Medicare: Accepting Medicare Assignments Practice Location: 602 N 6th Ave W, Virginia, MN 55792 Phone: 218-741-4111 Fax: 218-741-8966 |