Philip Russo Petrosky, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

0549995 Issued in KS

Practice address

10500 Quivira Rd
Overland Park, KS 66215-2306

Phone

(913) 541-5000

Fax

(913) 541-5625

NPI assigned

Mar 30, 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 KS, MO2 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

Specialty

Internal Medicine

Education

Kansas City University of Med & Biosciences, College of Osteo Med, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

KC Hospitalists PAGroup PAC ID 2860635117, 46 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lee'S Summit Medical Center Hospital, Lees Summit, MO, CCN 260190
• Overland Park Reg Med Ctr Hospital, Overland Park, KS, CCN 170176
• Menorah Medical Center Hospital, Overland Park, KS, CCN 170182
• University of Kansas Hospital Hospital, Kansas City, KS, CCN 170040

Merit-based Incentive Payment System (MIPS)

Final score

57.27 of 100Reported as group

Quality

44.91

Improvement activities

40

Cost

44.15

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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.

• KC Hospitalists, P.a.

  • Hospitalist Physician
  • Overland Park, KS
  • NPI 1922348069

  Internal Medicine, MO

  Medicare reassignment Care Compare group NPD
• Midwest Division - MMC, LLC

  • General Acute Care Hospital
  • Overland Park, KS
  • NPI 1255378337
  NPD (past)
• Midwest Division-Oprmc LLC

  • General Acute Care Hospital
  • Overland Park, KS
  • NPI 1578500484
  NPD (past)
• Midwest Division - LSH, LLC

  • General Acute Care Hospital
  • Lees Summit, MO
  • NPI 1225085871
  NPD (past)

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

• Midwest Division - MMC, LLC

  • General Acute Care Hospital
  • Overland Park, KS
  • NPI 1255378337
  Care Compare affiliation
• Midwest Division-Oprmc LLC

  • General Acute Care Hospital
  • Overland Park, KS
  • NPI 1578500484
  Care Compare affiliation
• University of Kansas Hospital Authority

  • General Acute Care Hospital
  • Kansas City, KS
  • NPI 1629369681
  Care Compare affiliation
• University of Kansas Hospital Authority

  • General Acute Care Hospital
  • Kansas City, KS
  • NPI 1649259656
  Care Compare affiliation
• Midwest Division - LSH, LLC

  • General Acute Care Hospital
  • Lees Summit, MO
  • NPI 1225085871
  Care Compare affiliation

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

{
    "created_epoch": "1617062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1114505419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12200 W 106TH ST STE 325",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662152305",
            "telephone_number": "913-541-6022",
            "fax_number": "913-541-5625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10500 QUIVIRA RD",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662152306",
            "telephone_number": "913-541-5000",
            "fax_number": "913-541-5625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROSKY",
        "first_name": "PHILIP",
        "middle_name": "RUSSO",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-30",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KS",
            "license": "0549995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Joseph Peterson, PT DPT
• Paul Peterson, CRNA
• Rachael Peterson
• Kristen Petrick, BCBA
• Harrison Lee Petrik, PT, DPT
• Jeanne Carol Pettijohn, LSCSW
• Alexander Pettit
• Carol Yvonne Pettus, COTA
• Katie Pettus
• Mark Noel Pettus, RPT

• Internal Medicine Physician in Overland Park, KS
• Providers in Overland Park, KS by specialty
• Internal Medicine Physician in Kansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; 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.