Active NPI
Yonique Petrece Petgrave, M.D.
- Pediatric Nephrology Physician
- Memphis, TN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nephrology Physician
- License
- 60407
- Practice address
- 51 N Dunlap St Ste 400
Memphis, TN 38105-4625 - Phone
- (901) 287-7337
- NPI assigned
- Jul 2, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 19723 | FL | |
| Pediatric Nephrology Physician | 2080P0210X | 60407 | TN | Primary |
Addresses
Primary practice location
51 N Dunlap St Ste 400
Memphis, TN 38105-4625
Mailing address
850 Poplar Ave BLDG 2
Memphis, TN 38105-4607
Phone (901) 287-8693
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN, TX
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Pediatric Medicine
- Education
- Other, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1935 Medical District Dr
Dallas, TX 75235-7701
Phone (214) 456-2383
Hospital & facility affiliations
- Childrens Medical Center Dialysis Unit
- Childrens Medical Ctr of Dallas
Merit-based Incentive Payment System (MIPS)
- Final score
- 82.87 of 100
- Quality
- 70.15
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 72.75
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19723 | FL | MD | Clinical Social Worker |
| 60407 | TN | MD | Pediatric Nephrology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Texas Southwestern Medical Center at Dallas | Current | Accepting new patients | |
| The University of Texas Southwestern Medical Center at Dallas | Current | Accepting new patients | |
| University of Texas Southwestern Medical Center at Dallas | Current | Accepting new patients | |
| University of Texas Southwestern Medical Center at Dallas | Past | Accepting new patients | |
| Children'S Health System of Texas | Past | Accepting new patients |
Locations
2222 Welborn St
Dallas, TX 75219
Phone (214) 559-5000
1935 Medical District Dr
Dallas, TX 75235
Phone (214) 456-2735
1935 Medical District Dr
Unit A
Dallas, TX 75235
420 E 6th St
Ste 202
Odessa, TX 79761
Phone (214) 648-9618
7609 Preston Rd
Plano, TX 75024
Phone (214) 456-2444
5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390
Organizations & group practices 6
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.
-
- Anesthesiology Physician
- Dallas, TX
- NPI 1942270566
-
- Pediatrics Physician
- Memphis, TN
- NPI 1093024101
-
- Clinical Medical Laboratory
- Dallas, TX
- NPI 1396832713
-
- Surgery Physician
- Dallas, TX
- NPI 1578533196
-
- Children's Hospital
- Dallas, TX
- NPI 1194743013
-
- Internal Medicine Physician
- Dallas, TX
- NPI 1760452767
Hospital & facility affiliations 1
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": "1404259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596153600000",
"number": "1235545849",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "850 POPLAR AVE BLDG 2",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381054607",
"telephone_number": "901-287-8693"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "51 N DUNLAP ST STE 400",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381054625",
"telephone_number": "901-287-7337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETGRAVE",
"first_name": "YONIQUE",
"middle_name": "PETRECE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-07-02",
"last_updated": "2020-07-31",
"certification_date": "2020-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "FL",
"license": "19723",
"primary": false
},
{
"code": "2080P0210X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Nephrology",
"state": "TN",
"license": "60407",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2020; 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.