NPIMap

Individual provider Active NPI

Gabriel L Petruccelli, MD

  • Orthopaedic Surgery Physician
  • Silver Spring, MD
National Provider Identifier
1255623690
Registry record updated Oct 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
A117457 Issued in CA
Practice address
1400 Forest Glen Road
Suite 400
Silver Spring, MD 20910-1482
Phone
(301) 589-3324
Fax
(301) 681-7575
NPI assigned
May 4, 2011
Last updated
Oct 12, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X A117457 CA Primary

Addresses

Primary practice location

1400 Forest Glen Road
Suite 400
Silver Spring, MD 20910-1482

Mailing address

1400 Forest Glen Road
Suite 400
Silver Spring, MD 20910-1482
Phone (301) 589-3324

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20130312000480 DC Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 5496924938 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Sports Medicine
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6000 Executive Blvd
Suite 300
Rockville, MD 20852-3803
Phone (301) 468-8999

6410 Rockledge Dr
Bethesda, MD 20817-1844

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)35
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Centers for Advanced Orthopaedics, LLC Orthopaedic Surgery CurrentSince Sep 1, 2013 Accepting new patients
Elliot R Goldstein MD & Joel R Schulman MD PA Orthopaedic Surgery CurrentSince Mar 1, 2018 Accepting new patients
Centers for Advanced Orthopaedics, LLC Orthopaedic Surgery Current Accepting new patients
Elliot R Goldstein MD & Joel R Schulman MD PA CurrentSince Mar 1, 2018 Accepting new patients
Centers for Advanced Orthopaedics, LLC Orthopaedic Surgery CurrentSince Sep 1, 2013 Accepting new patients
Greater Washington Orthopaedic Group Orthopaedic Surgery Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

19532 Doctors Dr
Germantown, MD 20874
Phone (301) 353-0341

3414 Olandwood Ct
Olney, MD 20832
Phone (301) 774-0500

6000 Executive Blvd
Ste 300
Rockville, MD 20852
Phone (301) 468-8999

1400 Forest Glen Rd
Ste 400
Silver Spring, MD 20910
Phone (301) 251-0509

Organizations & group practices 8

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.

Hospital & facility affiliations 3

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": "1304467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350000000000",
    "number": "1255623690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 FOREST GLEN ROAD",
            "address_2": "SUITE 400",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209101482",
            "telephone_number": "301-589-3324",
            "fax_number": "301-681-7575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 FOREST GLEN ROAD",
            "address_2": "SUITE 400",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209101482",
            "telephone_number": "301-589-3324",
            "fax_number": "301-681-7575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRUCCELLI",
        "first_name": "GABRIEL",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-04",
        "last_updated": "2012-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "CA",
            "license": "A117457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

Verify at the official NPI Registry.