Evis Petrela, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

003023 Issued in NY

Practice address

4900 Broad Rd
Suite 3P
Syracuse, NY 13215-2265

Phone

(315) 492-5910

Fax

(315) 492-5950

NPI assigned

Apr 2, 2008

Last updated

Jan 14, 2013By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 NY

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

Ophthalmology

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Familycare Medical Group PCGroup PAC ID 5193639565, 110 clinicians

Ophthalmological Associates of SracuseGroup PAC ID 8224071949, 2 clinicians

Ophthalmology Medical Service Group IncGroup PAC ID 0446248033, 30 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University Hospital S U N Y Health Science Center Hospital, Syracuse, NY, CCN 330241

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: epetrela@fcmg.medentdirect.com
• Direct secure messaging: epetrela7403@direct.upstate.edu

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.

• Familycare Medical Group, PC

  • Family Medicine Physician
  • Syracuse, NY
  • NPI 1447212063
  Medicare reassignment Care Compare group NPD
• Ophthalmological Associates of Syracuse MD,PC

  • Specialist
  • Syracuse, NY
  • NPI 1912900366
  Medicare reassignment Care Compare group NPD
• Ophthalmology Medical Service Group Inc

  • Ophthalmology Physician
  • Syracuse, NY
  • NPI 1225072051
  Medicare reassignment Care Compare group NPD

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

• Suny Health Science Center at Syracuse

  • General Acute Care Hospital
  • Syracuse, NY
  • NPI 1578554630
  Care Compare affiliation

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

{
    "created_epoch": "1207094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358121600000",
    "number": "1225200900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 BROAD RD",
            "address_2": "SUITE 3P",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132152265",
            "telephone_number": "315-492-5910",
            "fax_number": "315-492-5950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 BROAD RD",
            "address_2": "SUITE 3P",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132152265",
            "telephone_number": "315-492-5910",
            "fax_number": "315-492-5950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRELA",
        "first_name": "EVIS",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-02",
        "last_updated": "2013-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "NY",
            "license": "003023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Scott Michael Peterson, ATC
• Rosena Petit-Frere, CRNA
• Patricia Petkewec, RPH
• John Joseph Petosa Jr., MD
• Jennifer Lee Petranchuk
• Redion Bradley Petrela, MD
• Danielle Petrella
• Brandi Leigh Petrello, LCSW
• Jessica R Petrick, NP
• Jennifer Petrie, M.S.E.D.

• Ophthalmology Physician in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Ophthalmology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2013; 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.