Emily Sikes Petanovich, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

0618002857 Issued in VA

Practice address

843 W Stuart Dr
Hillsville, VA 24343-1577

Phone

(276) 728-9323

NPI assigned

Oct 10, 2016

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

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pennsylvania College of Optometry, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eye Care on the Ridge LLCGroup PAC ID 7719157700, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

49.17 of 100Reported as group

Quality

98.33

Improvement activities

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Eye Care on the Ridge LLC

  • Optometrist
  • Hillsville, VA
  • NPI 1063704435
  Medicare reassignment Care Compare group NPD
• Advanced Hearing Solutions LLC

  • Hearing and Speech Clinic/Center
  • Hillsville, VA
  • NPI 1538701768
  NPD

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

{
    "created_epoch": "1476057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583625600000",
    "number": "1235689613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "843 W STUART DR",
            "city": "HILLSVILLE",
            "state": "VA",
            "postal_code": "243431577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "843 W STUART DR",
            "city": "HILLSVILLE",
            "state": "VA",
            "postal_code": "243431577",
            "telephone_number": "276-728-9323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETANOVICH",
        "first_name": "EMILY",
        "middle_name": "SIKES",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-10",
        "last_updated": "2020-03-08",
        "certification_date": "2020-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "GA",
            "license": "OPT002981",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "VA",
            "license": "0618002857",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christine Alexandra Nogues, PSY.D.G
• David Norton, DPT, PT
• Patricia Goad Osborne, FNP-BC
• Christopher Shane Owens, LPTA
• Manuel Perez
• Phipps Enterprise Inc
• Mattie A Phipps, RPH
• Ethan Pratt
• PT Solutions, LLC
• Joshua S Ramey, DDS

• Optometrist in Hillsville, VA
• Providers in Hillsville, VA by specialty
• Optometrist in Virginia

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

Verify at the official NPI Registry.