Carol Petruff, MD

Primary specialty

Gastroenterology PhysicianTaxonomy code 207RG0100X

License

033353 Issued in CT

Practice address

44 Dale Rd
Prime Healthcare
Avon, CT 06001-3612

Phone

(860) 674-8830

Fax

(860) 674-8984

NPI assigned

Dec 23, 2005

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CT

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 1

Specialty

GastroenterologyAlso: Internal Medicine

Education

State University of Ny Upstate Medical University, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prime Healthcare, PCGroup PAC ID 6709787930, 67 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Francis Hospital & Medical Center Hospital, Hartford, CT, CCN 070002

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: carol.petruff.1@31712.direct.athenahealth.com
• Direct secure messaging: cpetruff16095@direct.stfranciscare.org

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

• Prime Healthcare, PC

  • Internal Medicine Physician
  • Wethersfield, CT
  • NPI 1184819302

  Gastroenterology

  Medicare reassignment Care Compare group NPD
• Prime Healthcare (Sleep Lab)

  • Sleep Disorder Diagnostic Clinic/Center
  • Wethersfield, CT
  • NPI 1184832354
  NPD
• Ajt Urology LLC

  • Non-Pharmacy Dispensing Site
  • Bloomfield, CT
  • NPI 1760283576
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Saint Francis Hospital and Medical Center

  • Psychiatric Hospital Unit
  • Hartford, CT
  • NPI 1144234428
  Care Compare affiliation
• Saint Francis Hospital and Medical Center

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1407833486
  Care Compare affiliation
• Saint Francis Hospital and Medical Center

  • General Acute Care Hospital
  • Hartford, CT
  • NPI 1871713495
  Care Compare affiliation

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

{
    "created_epoch": "1135296000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1083691794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 JORDAN LN",
            "address_2": "PRIME HEALTHCARE",
            "city": "WETHERSFIELD",
            "state": "CT",
            "postal_code": "061091278",
            "telephone_number": "860-263-0253",
            "fax_number": "860-263-0262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 DALE RD",
            "address_2": "PRIME HEALTHCARE",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060013612",
            "telephone_number": "860-674-8830",
            "fax_number": "860-674-8984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRUFF",
        "first_name": "CAROL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-23",
        "last_updated": "2023-03-07",
        "certification_date": "2021-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CT",
            "license": "033353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "010033353CT01",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001333533",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "033353",
            "state": "CT"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cpetruff16095@direct.stfranciscare.org",
            "affiliation": "N",
            "endpointDescription": "Prime Healthcare Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "44 Dale Rd",
            "address_2": "Prime Healthcare",
            "city": "Avon",
            "state": "CT",
            "country_code": "US",
            "postal_code": "060013612",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kenneth Perks, M.D.
• Tiffany T Perri, O.D.
• Kathryn Michelle Perrone, PT, DPT
• Sasha Perry, PMHNP
• Liliana Petrov
• Kelly Pfeiffer, APRN
• Toniane Picozzo, CCC-SLP
• Amanda Nicole Pitruzzello, SLP
• Aubrey Nichole Poisson
• Aleksandra Poka

• Gastroenterology Physician in Avon, CT
• Providers in Avon, CT by specialty
• Gastroenterology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.