Individual provider Active NPI

Brian Petronaci, PA-C

  • Physician Assistant
  • Austin, TX
National Provider Identifier
1225401730
Registry record updated Jan 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
4316 James Casey BLDG F, #201
Austin, TX 78745
Phone
(512) 266-3377
NPI assigned
Nov 5, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00382200 NJ
Surgical Physician Assistant 363AS0400X 25MP00382200 NJ
Physician Assistant 363A00000X TX Primary

Addresses

Primary practice location

4316 James Casey BLDG F, #201
Austin, TX 78745

Mailing address

4316 James Casey BLDG F, #201
Austin, TX 78745
Phone (512) 266-3377

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, 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

Enrollment IDStateProvider typePAC IDDetails
I20151210001264 NJ Practitioner - Physician Assistant 9931400256 Reassigns benefits to 1 organization
I20230302000531 TX Practitioner - Physician Assistant 9931400256 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Joint Pain and Orthopedics, PLLCGroup PAC ID 7416375266, 10 clinicians

Practice addresses (Care Compare)

4316 James Casey St
Suite 201
Austin, TX 78745-1116
Phone (512) 266-3377

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
25MP00382200NJMDSurgical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: brian.petronaci.1@22579.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1446681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1225401730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4316 JAMES CASEY BLDG F, #201",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78745",
            "telephone_number": "512-266-3377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4316 JAMES CASEY BLDG F, #201",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "78745",
            "telephone_number": "512-266-3377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRONACI",
        "first_name": "BRIAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-11-05",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00382200",
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NJ",
            "license": "25MP00382200",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austin, TX

Sources for this page

Verify at the official NPI Registry.