Travis Petrick, NP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

95012917 Issued in CA

Practice address

15353 Weddington St Apt C107
Sherman Oaks, CA 91411-3844

Phone

(310) 469-1374

NPI assigned

Sep 27, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, HI2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Queens University Medical GroupGroup PAC ID 2466831557, 614 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• The Queens Medical Center Hospital, Honolulu, HI, CCN 120001

Merit-based Incentive Payment System (MIPS)

Final score

97.52 of 100Reported as group

Quality

97.68

Improvement activities

40

Cost

62.65

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tpetrick575145@direct.llu.edu

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.

• Queens University Medical Group

  • Multi-Specialty Clinic/Center
  • Honolulu, HI
  • NPI 1891441382
  Medicare reassignment Care Compare group NPD
• Desert Trauma Surgeons, Inc.

  • Surgical Critical Care Physician
  • Lynwood, CA
  • NPI 1144225426
  Medicare reassignment NPD
• El-Bershawi Medical Corp

  • Critical Care Medicine (Internal Medicine) Physician
  • Riverside, CA
  • NPI 1386813103
  Medicare reassignment NPD
• Pacific Professional Surgical Group Inc

  • Trauma Surgery Physician
  • Riverside, CA
  • NPI 1578341608
  NPD (past)

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

• The Queens Medical Center

  • General Acute Care Hospital
  • Honolulu, HI
  • NPI 1184612764
  Care Compare affiliation

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

{
    "created_epoch": "1569542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569542400000",
    "number": "1255982492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15353 WEDDINGTON ST APT C107",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914113844",
            "telephone_number": "310-469-1374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15353 WEDDINGTON ST APT C107",
            "city": "SHERMAN OAKS",
            "state": "CA",
            "postal_code": "914113844",
            "telephone_number": "310-469-1374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRICK",
        "first_name": "TRAVIS",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-27",
        "last_updated": "2019-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "CA",
            "license": "95012917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Miao MD Inc
• Peter P. Koenig, M.D., Incorporated
• Lois Peters
• Rebecca Karen Peterson, PSYD
• Edward Petko, M.D.
• Korinne Nicole Petris, OTR/L
• Stephanie Petrow, LAC
• Shirin Peykar, LMFT
• Kimberlynn Damasco Pham
• Michelle Pham

• Acute Care Nurse Practitioner in Sherman Oaks, CA
• Providers in Sherman Oaks, CA by specialty
• Acute Care Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2019; 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.