Patrick Pietrzak

Primary specialty

DentistTaxonomy code 122300000X

License

DN26052 Issued in FL

Practice address

8286 A1A S
Saint Augustine, FL 32080-8307

Phone

(952) 843-3057

NPI assigned

Jul 31, 2021

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dentist

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• DHHS PHS IHS Phoenix Area

  • Clinic/Center
  • Winterhaven, CA
  • NPI 1265719918

  TX

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1627689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627689600000",
    "number": "1003589367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8286 A1A S",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320808307",
            "telephone_number": "952-843-3057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8286 A1A S",
            "city": "SAINT AUGUSTINE",
            "state": "FL",
            "postal_code": "320808307",
            "telephone_number": "952-843-3057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIETRZAK",
        "first_name": "PATRICK",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-31",
        "last_updated": "2021-07-31",
        "certification_date": "2021-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN26052",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Physical Therapy on Demand LLC
• Physician Associates Group, Inc.
• Amy M Piazza, OTRL CHT
• Carolyn Piazza
• N'Mya J Pierce
• Kellie Erin Pike-Delamerens, RDN LDN MSCHN
• Joseph Pileggi
• Benoit C Pineau, MD
• Bartlomiej Danial Piniaz, CBC
• Paula C Pinkerton, BA

• Dentist in Saint Augustine, FL
• Providers in Saint Augustine, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.