PATCHOUCO THEODORE MD
NPI 1528628963
Family Medicine in Knoxville, TN

Q: What is Patchouco Theodore's NPI number?

The NPI number for Patchouco Theodore is 1528628963. It was assigned to this individual provider in the NPPES registry on June 18, 2019.

Q: What is Patchouco Theodore's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since June 18, 2019PECOS Enrolled

1924 ALCOA HWY # U-67, KNOXVILLE, TN 37920(865) 305-9350(865) 305-8942 Get Directions Write a Review

NPPES record last updated: December 10, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Dec 10, 2025, Feb 22, 2023, Jul 18, 2019 and 1 more (4 updates tracked since 2019).

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About Patchouco Theodore Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PATCHOUCO THEODORE MD (NPI 1528628963) is an individual family medicine provider in Knoxville, Tennessee, licensed in Louisiana (350083) and active in the NPI registry since June 2019. He is enrolled in Medicare PECOS, is affiliated with Valley Baptist Medical Center- Brownsville, and is a graduate of Other (2018).

NPPES Registry Identity

NPI1528628963

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NamePATCHOUCO THEODORECredential: MD

Location Address1924 ALCOA HWY # U-67Knoxville, TN 37920-1511

Mailing Address10300 Sw 216th StCutler Bay, FL 33190-1003

Phone(865) 305-9350

Fax(865) 305-8942

Sole ProprietorYes

Medical School CMSOtherGraduated 2018

Enumeration DateJune 18, 2019

Last NPPES UpdateDecember 10, 20254 updates tracked since enumeration

NPPES CertifiedDecember 10, 2025

✔ NPI 1528628963 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in LA · 350083

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedEmergency MedicineTaxonomy 207P00000X · License 66626 (TN)

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1924 ALCOA HWY # U-67, Knoxville, TN 37920

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas, Oscar Insurance Company, Sendero Health Plans, Local Nonprofit.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Patchouco Theodore Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6002297231

PECOS Enrollment IDI20260112001731, I20260216001308

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Critical care, first 30-74 minutes 99291

Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.

138 services130 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only 93010

A routine electrocardiogram (ECG) with 12 leads is a simple, non-invasive test that records the electrical activity of your heart. It helps in identifying heart conditions by detecting irregularities in your heart rhythms. The results are interpreted and a report is provided.

110 services104 patients

Emergency department visit with high level of medical decision making 99285

An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.

102 services99 patients

Emergency department visit with moderate level of medical decision making 99284

An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.

69 services67 patients

Emergency department visit with low level of medical decision making 99283

An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.

14 services14 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Valley Baptist Medical Center- Brownsville

Acute Care Hospitals · Brownsville, TX

3/5 CMS rating

OwnershipProprietary

CMS Certification Number450028

Location1040 W Jefferson StBrownsville, TX 78520 · Cameron County

Emergency services Birthing friendly

Vhs Harlingen Hospital Company LLC

Acute Care Hospitals · Harlingen, TX

2/5 CMS rating

OwnershipProprietary

CMS Certification Number450033

Location2101 Pease StHarlingen, TX 78550 · Cameron County

Emergency services Birthing friendly

Davis Medical Center

Acute Care Hospitals · Elkins, WV

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number510030

Location812 Gorman AvenueElkins, WV 26241 · Randolph County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 37920 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$81.53 typical visit price

range $52.64 – $160.89

Typical copayment $20.38 (range $13.16 – $40.22)

Most-billed visit code 99203

Established Patient

$93.60 typical visit price

range $16.72 – $131.41

Typical copayment $23.40 (range $4.18 – $32.85)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ZAID AHMAD MD

Student in an Organized Health Care Education/Training Program