Nicole Ramos Petro, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

1083930 Issued in CA

Practice address

355 Lennon LN Ste 255
Walnut Creek, CA 94598

Phone

(925) 932-7704

NPI assigned

Nov 13, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA, TX2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pinnacle Dermatology SCGroup PAC ID 8628353380, 145 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.8 of 100Reported as group

Promoting interoperability

88

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Pinnacle Dermatology, SC

  • Dermatology Physician
  • Joliet, IL
  • NPI 1861930984

  TX

  Medicare reassignment Care Compare group
• Golden State Dermatology Associates, Inc.

  • Dermatology Physician
  • Walnut Creek, CA
  • NPI 1700860871
  Medicare reassignment
• Daniel J Ladd DO PA

  • Dermatology Physician
  • Austin, TX
  • NPI 1326238296
  Medicare reassignment
• Golden State Dermatology Associates, Inc.

  • Ambulatory Surgical Clinic/Center
  • Fresno, CA
  • NPI 1235738576
  NPD
• Daniel J Ladd Jr DO PA Dba Austin Center for Skin Health and Rejuvenat

  • Dermatology Physician
  • Bastrop, TX
  • NPI 1831334291
  NPD

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

{
    "created_epoch": "1226534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1134373392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2435 WEBSTER ST",
            "address_2": "STE 101",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052050",
            "telephone_number": "925-932-7704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 LENNON LN STE 255",
            "city": "WALNUT CREEK",
            "state": "CA",
            "postal_code": "94598",
            "telephone_number": "925-932-7704"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4112 Links Ln Ste 205",
            "address_purpose": "LOCATION",
            "city": "Round Rock",
            "state": "TX",
            "postal_code": "786643903",
            "country_code": "US",
            "telephone_number": "512-451-0139",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETRO",
        "first_name": "NICOLE",
        "middle_name": "RAMOS",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-13",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA15806",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "1083930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCCPA",
            "identifier": "1083930",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leah Taylor Peterson, AU.D.
• Linda Marie Peterson, CNM
• Marion Macphail Peterson, RN MFT
• Shannon Peterson, M.D.
• John Joseph Petrini Jr., D.D.S, M.S.
• Stacey Elizabeth Petrowsky, MA, LMFT
• David Lewis Pfeifer
• Elizabeth Pfeiffer
• Jessica Rachel Pfisterer, AMFT
• Stephanie Phalip, M.D.

• Medical Physician Assistant in Walnut Creek, CA
• Providers in Walnut Creek, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2022; 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.