Individual provider Active NPI

Mark Petrocelli, D.O.

  • Orthopaedic Surgery Physician
  • Pittsburgh, PA
National Provider Identifier
1033344171
Registry record updated Jan 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
OS021275 Issued in PA
Practice address
9104 Babcock Blvd FL 5
Pittsburgh, PA 15237-5866
Phone
(412) 748-7444
NPI assigned
May 19, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X 5101018133 MI
Orthopaedic Surgery Physician 207X00000X OS021275 PA Primary

Addresses

Primary practice location

9104 Babcock Blvd FL 5
Pittsburgh, PA 15237-5866

Mailing address

9104 Babcock Blvd FL 5
Pittsburgh, PA 15237-5866
Phone (412) 748-7444

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mark.a.petrocelli@upmcdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, PA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160210001169 MI Practitioner - Orthopedic SurgeryPractitioner - Hand Surgery 8325342496 Reassigns benefits to 1 organization
I20231219000397 PA Practitioner - Orthopedic Surgery 8325342496 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101018133MIMDOrthopaedic Surgery Physician
OS021275PAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic Associates of Port Huron PC Orthopaedic Surgery CurrentSince Jan 1, 2019 Accepting new patients
Upmc Community Medicine, Inc Current Accepting new patients
University of Pittsburgh Physicians Orthopaedic Surgery CurrentSince Nov 13, 2023 Accepting new patients
Upmc Community Medcine Inc CurrentSince Nov 13, 2023 Accepting new patients
University of Pittsburgh Physicians Current Accepting new patients
Upmc Community Medicine Inc CurrentSince Nov 13, 2023 Accepting new patients
University of Pittsburgh Physicians CurrentSince Nov 13, 2023 Accepting new patients
Upmc Community Medicine Inc Orthopaedic Surgery PastSince Jan 28, 2024 Accepting new patients
Orthopedic Associates of Port Huron PC Orthopaedic Surgery Past Accepting new patients
Upmc Altoona Regional Health Services, Inc PastSince Jan 28, 2024 Accepting new patients

Locations

940 River Centre Dr
Port Huron, MI 48060
Phone (810) 985-4900

2 Hot Metal St
#One
Pittsburgh, PA 15203
Phone (412) 432-5864

339 6th Ave
Fl 5
Pittsburgh, PA 15222
Phone (412) 560-8762

3471 5th Ave
Ste 1010
Pittsburgh, PA 15213
Phone (412) 605-3254

9104 Babcock Blvd
Fl 5
Pittsburgh, PA 15237
Phone (412) 748-7407

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/AIIFDD

Organizations & group practices 10

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": "1242691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705881600000",
    "number": "1033344171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9104 BABCOCK BLVD FL 5",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152375866",
            "telephone_number": "412-748-7444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9104 BABCOCK BLVD FL 5",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152375866",
            "telephone_number": "412-748-7444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROCELLI",
        "first_name": "MARK",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-05-19",
        "last_updated": "2024-01-22",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MI",
            "license": "5101018133",
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "PA",
            "license": "OS021275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mark.a.petrocelli@upmcdirect.com",
            "affiliation": "N",
            "address_1": "600 Grant St",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.