NPIMap

Individual provider Active NPI

Kaitlyn M Petrakis, CRNP

  • Family Nurse Practitioner
  • Pittsburgh, PA
National Provider Identifier
1255839593
Registry record updated Nov 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP018408 Issued in PA
Practice address
310 Rodi Rd Ste 100
Pittsburgh, PA 15235-3318
Phone
(412) 242-0777
Fax
(412) 242-5174
NPI assigned
Jan 31, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP018408 PA Primary

Addresses

Primary practice location

310 Rodi Rd Ste 100
Pittsburgh, PA 15235-3318

Mailing address

3824 Northern Pike Ste 700
Monroeville, PA 15146-2184
Phone (412) 457-0060

Other names 1

  • Kaitlyn M Green Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address kaitlyngreen@pmapa.allscriptsdirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20180319000203 PA Practitioner - Nurse Practitioner 2769744416 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
PT Family Medicine PCGroup PAC ID 7315285053, 4 clinicians

Practice addresses (Care Compare)

2057 State Route 130
Jeannette, PA 15644-3801
Phone (724) 527-2700

Hospital & facility affiliations

  • Allegheny Health Network Healthcare at Home Home H Home health agency, Warrendale, PA, CCN 398069
  • Excela Health Westmoreland Regional Hospital Hospital, Greensburg, PA, CCN 390145
  • Forbes Hospital Hospital, Monroeville, PA, CCN 390267

Merit-based Incentive Payment System (MIPS)

Final score
93.9 of 100Reported as apm
Quality
85.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP018408PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Medical Associates, PC CurrentSince Mar 12, 2018 Accepting new patients
PT Family Medicine PC CurrentSince Dec 1, 2024 Accepting new patients
Premier Medical Associates PC CurrentSince Mar 12, 2018 Accepting new patients

Locations

2057 State Route 130
Jeannette, PA 15644
Phone (724) 527-0991

3824 Northern Pike
Ste 300
Monroeville, PA 15146
Phone (412) 856-5335

3824 Northern Pike
Ste 200
Monroeville, PA 15146
Phone (412) 380-2800

3824 Northern Pike
Ste 700
Monroeville, PA 15146
Phone (412) 457-0060

310 Rodi Rd
Ste 100
Pittsburgh, PA 15235
Phone (412) 242-0777

Interoperability endpoints

  • Direct secure messaging: kpetrakis627920@direct.ahn.org
  • Direct secure messaging: kaitlyn.petrakis.1@20720.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/20720/brand/1/csg/1/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 11

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": "1517356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604361600000",
    "number": "1255839593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3824 NORTHERN PIKE STE 700",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151462184",
            "telephone_number": "412-457-0060",
            "fax_number": "412-457-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 RODI RD STE 100",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152353318",
            "telephone_number": "412-242-0777",
            "fax_number": "412-242-5174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRAKIS",
        "first_name": "KAITLYN",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-31",
        "last_updated": "2020-11-03",
        "certification_date": "2020-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP018408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kaitlyngreen@pmapa.allscriptsdirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "310 Rodi Rd Ste 100",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152353318",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "KAITLYN",
            "last_name": "GREEN",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.