NPIMap

Individual provider Active NPI

Thomas Petryk, MD

  • Family Medicine Physician
  • Newark, OH
National Provider Identifier
1245210244
Registry record updated May 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35060761 Issued in OH
Practice address
1930 Tamarack Rd
Newark, OH 43055-2303
Phone
(740) 522-7600
Fax
(740) 522-6399
NPI assigned
Jan 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35060761 OH Primary

Addresses

Primary practice location

1930 Tamarack Rd
Newark, OH 43055-2303

Mailing address

1930 Tamarack Rd
Newark, OH 43055-2303
Phone (740) 522-7600

Other identifiers 1

IdentifierTypeStateIssuer
0812704MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100901000068 OH Practitioner - Family Practice 0446374268 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Wright State University Boonshoft School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Medical and Surgical Associates IncGroup PAC ID 5890760938, 9 clinicians

Practice addresses (Care Compare)

1930 Tamarack Rd
Newark, OH 43055-2303
Phone (740) 522-7600

Hospital & facility affiliations

  • Premier Home Health LLC Home health agency, Newark, OH, CCN 369198
  • Centerwell Home Health II Home health agency, Mount Vernon, OH, CCN 368015
  • Absolute Hospice Inc Hospice, North Canton, OH, CCN 361683
  • Hospice of Central Ohio Hospice, Newark, OH, CCN 361525
  • Licking Memorial Hospital Hospital, Newark, OH, CCN 360218
  • Genesis Hospital Hospital, Zanesville, OH, CCN 360039
  • Riverside Methodist Hospital Hospital, Columbus, OH, CCN 360006
  • James Cancer Hospital & Solove Research Institute Hospital, Columbus, OH, CCN 360242
  • Flint Ridge NRSG & Rehab Ctr Nursing home, Newark, OH, CCN 365485
  • Altercare Newark North Inc. Nursing home, Newark, OH, CCN 365481
  • Altercare Newark South Inc. Nursing home, Newark, OH, CCN 366196

Merit-based Incentive Payment System (MIPS)

Final score
89.61 of 100Reported as group
Quality
97.53
Improvement activities
40
Cost
68.67

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy20

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35060761OHMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical and Surgical Associates Inc Family Medicine CurrentSince Aug 5, 2002 Accepting new patients
Altercare Newark North, Inc. Past Accepting new patients
Altercare Newark South, Inc. Past Accepting new patients

Locations

1930 Tamarack Rd
Newark, OH 43055
Phone (740) 344-6901

Interoperability endpoints

  • Direct secure messaging: tpetryk@masai-oh.direct.office.nextgen.com
  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

Organizations & group practices 3

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 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304640000000",
    "number": "1245210244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1930 TAMARACK RD",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430552303",
            "telephone_number": "740-522-7600",
            "fax_number": "740-522-6399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1930 TAMARACK RD",
            "city": "NEWARK",
            "state": "OH",
            "postal_code": "430552303",
            "telephone_number": "740-522-7600",
            "fax_number": "740-522-6399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRYK",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2011-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35060761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0812704",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, OH

Sources for this page

Verify at the official NPI Registry.