JONA PATALINO
Complete NPI Record 1639222771
Nurse Practitioner - Family in Oneida, NY
Active since January 20, 2007PECOS EnrolledAccepts Medicare Assignment
Complete NPI Dataset
This page contains the complete raw NPPES record for Jona Patalino (NPI 1639222771), an individual nurse practitioner provider in Oneida, NY. All 30 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, Markdown or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1639222771 Field 1/30
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 1 Field 2/30
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Provider Last Name Legal Name: PATALINO Field 3/30
- The last name of the provider. If the provider is an individual, this is the legal name.
- Provider First Name: JONA Field 4/30
- The first name of the provider, if the provider is an individual.
- Provider First Line Business Mailing Address: 100 METROPOLITAN PARK DR STE 100 Field 5/30
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: LIVERPOOL Field 6/30
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: NY Field 7/30
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 130887112 Field 8/30
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 9/30
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 3158709369 Field 10/30
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider Business Mailing Address Fax Number: 3158709364 Field 11/30
- The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
- Provider First Line Business Practice Location Address: 357 GENESEE ST STE 1 Field 12/30
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: ONEIDA Field 13/30
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: NY Field 14/30
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 134212658 Field 15/30
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 16/30
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 3153638862 Field 17/30
- The telephone number associated with the location address of the provider being identified.
- Provider Business Practice Location Address Fax Number: 3153633326 Field 18/30
- The fax number associated with the location address of the provider being identified.
- Provider Gender Code: F Field 21/30
- The code designating the provider's gender if the provider is a person.
- Healthcare Provider Taxonomy Code 1: 363LF0000X Field 22/30
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 1: 334396 Field 23/30
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 1: NY Field 24/30
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 1: Y Field 25/30
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Other Provider Identifier 1: 02776649 Field 26/30
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 1: 05 Field 27/30
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 1: NY Field 28/30
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Is Sole Proprietor: N Field 29/30
- Indicates whether the provider is registered as a sole proprietor. This is a single-character code: "Y" means the provider operates as a sole proprietor, and "N" means they do not.
Secondary Practice Locations 7
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
192 Genesee St
Location 1/7Auburn, NY 13021-3361 · Phone (315) 258-5253 · Fax (315) 258-0202
5700 W Genesee St Ste 124
Location 2/7Camillus, NY 13031-3206 · Phone (315) 478-4185 · Fax (315) 478-0840
4211 Medical Center Dr Ste 211
Location 3/7Fayetteville, NY 13066-6637 · Phone (315) 329-0210 · Fax (315) 329-0215
80 E Main St Ste 2A
Location 4/7Canton, NY 13617-1450 · Phone (315) 714-2559 ext. 42559 · Fax (315) 386-3056
5100 W Taft Rd Ste 4D
Location 5/7Liverpool, NY 13088-3810 · Phone (315) 458-6669 · Fax (315) 458-0819
1226 E Water St
Location 6/7Syracuse, NY 13210-1155 · Phone (315) 478-4185 · Fax (315) 478-0840
2 Ellinwood Dr
Location 7/7New Hartford, NY 13413-1102 · Phone (315) 724-1012 · Fax (315) 724-5219
Other Provider Identifiers 1
Legacy and payer-issued identifiers reported to the NPPES registry for this provider.
02776649 Medicaid
Identifier 1/1State: NY
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
Medicaid (State-specific): A provider identification number assigned by an individual state's Medicaid program, used for billing and enrollment within that state's Medicaid system.
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