Individual provider Active NPI

Jean-Pierre Petrel II, PA-C

  • Physician Assistant
  • Las Vegas, NV
National Provider Identifier
1003689324
Registry record updated Jan 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2931 Issued in NV
Practice address
4785 S Durango Dr Ste 101
Las Vegas, NV 89147-8167
Phone
(702) 901-4233
NPI assigned
Oct 30, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA2931 NV Primary
Medical Physician Assistant 363AM0700X PA2931 NV
Surgical Physician Assistant 363AS0400X PA2931 NV

Addresses

Primary practice location

4785 S Durango Dr Ste 101
Las Vegas, NV 89147-8167

Mailing address

4785 S Durango Dr Ste 101
Las Vegas, NV 89147-8167
Phone (702) 889-8444

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240416000626 NV Practitioner - Physician Assistant 3375982960 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA2931NVMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dignity Health Past Accepting new patients
Wee Care Pediatrics Past Accepting new patients

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1698624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769040000000",
    "number": "1003689324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4785 S DURANGO DR STE 101",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891478167",
            "telephone_number": "702-889-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4785 S DURANGO DR STE 101",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891478167",
            "telephone_number": "702-901-4233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETREL",
        "first_name": "JEAN-PIERRE",
        "name_suffix": "II",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-10-30",
        "last_updated": "2026-01-22",
        "certification_date": "2026-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NV",
            "license": "PA2931",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NV",
            "license": "PA2931",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NV",
            "license": "PA2931",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.