Provider Demographics
NPI:1730115239
Name:ESCALANTE, PATRICIO (MD)
Entity Type:Individual
Prefix:DR
First Name:PATRICIO
Middle Name:
Last Name:ESCALANTE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 1ST ST SW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55905-0001
Mailing Address - Country:US
Mailing Address - Phone:507-284-2511
Mailing Address - Fax:
Practice Address - Street 1:200 1ST ST SW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55905-0001
Practice Address - Country:US
Practice Address - Phone:507-284-2511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2020-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA67280207RC0200X, 207RP1001X
MN103512207RP1001X
MN50498207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A672800OtherBLUE SHIELD
CA00A672800Medicaid
IAENROLLEDMedicaid
CA1356390009OtherGROUP NPI
MN796495000Medicaid
SDENROLLEDMedicaid
MNP00835579OtherMEDICARE - RAILROAD
CA00A672800197OtherCAL OPTIMA
CAGR0016910OtherGROUP MEDICAID
CAW11675OtherGROUP MEDICARE PIN
CA290013642OtherRAILROAD MEDICARE
CACE1617OtherGROUP RAILROAD MEDICARE
MN796495000Medicaid
CAWA67280AMedicare PIN
MN290000570Medicare PIN