Ognjen Petras, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A79598 Issued in CA

Practice address

2171 Junipero Serra Blvd
Suite 510
Daly City, CA 94014-1906

Phone

(650) 301-0556

NPI assigned

Jan 5, 2009

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 CA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1231113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1421280000000",
    "number": "1083850598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1222 CLAYTON ST APT 30",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941141851",
            "telephone_number": "415-385-5498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2171 JUNIPERO SERRA BLVD",
            "address_2": "SUITE 510",
            "city": "DALY CITY",
            "state": "CA",
            "postal_code": "940141906",
            "telephone_number": "650-301-0556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRAS",
        "first_name": "OGNJEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-01-05",
        "last_updated": "2015-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A79598",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Laurie Petronis, COUNSELOR
• Nancy A. Petty, OTR CHT
• Dominic Phan-Romero
• Jackie Phan, M.D.
• Niam Phan, OD

• Internal Medicine Physician in Daly City, CA
• Providers in Daly City, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.