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DR. SHANE MICHAEL PATTERSON M.D.
NPI 1639367410
Family Medicine in San Andreas, CA

Active since October 05, 2007Opted out of Medicare · through Jul 1, 2027
702 MOUNTAIN RANCH RD, SAN ANDREAS, CA 95249(209) 754-0870(209) 754-0878 Get Directions Write a Review

NPPES record last updated: January 18, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Shane Michael Patterson M.d. NPPES

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

DR. SHANE MICHAEL PATTERSON M.D. (NPI 1639367410) is an individual family medicine provider in San Andreas, California, licensed in California (A101166) and active in the NPI registry since October 2007. He has opted out of Medicare through July 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1639367410
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameDR. SHANE MICHAEL PATTERSONCredential: M.D.
Location Address702 MOUNTAIN RANCH RDSan Andreas, CA 95249
Mailing AddressPo Box 636San Andreas, CA 95249-0636 · (209) 754-0870 · Fax (209) 754-0878
Phone(209) 754-0870
Fax(209) 754-0878
Sole ProprietorYes
Enumeration DateOctober 5, 2007
Last NPPES UpdateJanuary 18, 2013
✔ NPI 1639367410 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CA · A101166
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 ListedFamily Medicine · Geriatric MedicineTaxonomy 207QG0300X · License A101166 (CA)
702 MOUNTAIN RANCH RD, San Andreas, CA 95249
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Shane Michael Patterson M.d. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 1, 2017 through July 1, 2027.

Opt-Out Effective DateJuly 1, 2017
Opt-Out In Effect ThroughJuly 1, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95249 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
$90.32 typical visit price
range $58.87 – $176.60
Typical copayment $22.58 (range $14.71 – $44.15)
Most-billed visit code 99203
Established Patient
$103.36 typical visit price
range $19.28 – $144.60
Typical copayment $25.84 (range $4.82 – $36.15)
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 4

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

MATTHEW JOSHUA KING-LUNG KOR MD
Family Medicine
702 MOUNTAIN RANCH RD
SAN ANDREAS, CA 95249
Calaveras County (092) 754-4564
MR. PETER FORREST OLIVER MD
Surgery
702 MOUNTAIN RANCH RD
SAN ANDREAS, CA 95249
Calaveras County (209) 754-0870
SILVER OAK MEDICAL OFFICE INC
Surgery
702 MOUNTAIN RANCH RD
SAN ANDREAS, CA 95249
Calaveras County (209) 754-0870
MRS. SARAH MARGARET GRIMES MD
Family Medicine
702 MOUNTAIN RANCH RD
SAN ANDREAS, CA 95249
Calaveras County (209) 754-0870

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shane Patterson's NPI number?

The NPI number for Shane Patterson is 1639367410. It was assigned to this individual provider in the NPPES registry on October 5, 2007.

Where is Shane Patterson located?

Shane Patterson practices at 702 Mountain Ranch Rd, San Andreas, CA 95249. The listed phone number is (209) 754-0870.

What is Shane Patterson's specialty?

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

Is Shane Patterson enrolled in Medicare?

No. Shane Patterson has opted out of Medicare through July 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Shane Patterson was last updated on January 18, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.