Active NPI
Dmitriy Petrov, MD
- Neurological Surgery Physician
- Philadelphia, PA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurological Surgery Physician
- License
- MD451566
- Practice address
- 3400 Spruce St
3 Silverstein
Philadelphia, PA 19104-4238 - Phone
- (215) 662-3487
- Fax
- (215) 349-5534
- NPI assigned
- Jun 9, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurological Surgery Physician | 207T00000X | MD451566 | PA | Primary |
Addresses
Primary practice location
3400 Spruce St
3 Silverstein
Philadelphia, PA 19104-4238
Mailing address
3400 Spruce St
3 Silverstein
Philadelphia, PA 19104-4238
Phone (215) 662-3487
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA, NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Neurosurgery
- Education
- Other, 2011
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
10201 66TH Rd
Forest Hills, NY 11375-2029
Phone (718) 830-4000
17660 Union Tpke
Fresh Meadows, NY 11366-1526
Phone (718) 820-9015
27005 75TH Ave
New Hyde Park, NY 11040-1402
27005 76TH Ave GF
New Hyde Park, NY 11040-1402
Phone (718) 470-7501
300 Community Dr
Manhasset, NY 11030-3816
300 Community Dr LL
Manhasset, NY 11030-3816
Phone (516) 562-2229
330 Community Dr
Manhasset, NY 11030-3816
Phone (516) 708-2550
350 Community Dr
Manhasset, NY 11030-3816
Phone (516) 562-3845
800 Northern Blvd
Great Neck, NY 11021-5314
95 -25 Queens Boulevard
Rego Park, NY 11374-4510
Phone (718) 925-6565
9525 Queens Blvd
Rego Park, NY 11374-4510
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.91 of 100
- Quality
- 73.58
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 76.13
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Spinal fusion | 51 |
| Laminectomy or laminotomy (partial removal of spine bones) | 24 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Penn-Medical Group | Current | Accepting new patients | |
| University of Penn-Medical Group | Current | Accepting new patients | |
| North Shore-Lij Medical PC | Neurological Surgery | Current | Accepting new patients |
| University of Penn-Medical Group | Current | Accepting new patients | |
| Presbyterian Medical Center of the University of Pennsylvania Health S | Past | Accepting new patients | |
| Long Island Jewish Medical Center | Past | Accepting new patients |
Locations
10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091
17660 Union Tpke
Ste 350
Fresh Meadows, NY 11366
Phone (718) 521-6200
805 Northern Blvd
Ste 100
Great Neck, NY 11021
Phone (516) 550-2100
1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650
300 Community Dr
Plandome, NY 11030
3400 Spruce St
Fl 3
Philadelphia, PA 19104
3400 Civic Center Blvd
Fl 2
Philadelphia, PA 19104
3624 Market St
Fl 2
Philadelphia, PA 19104
Phone (215) 615-3669
Networks
- Healthfirst Medicare Network H5989
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
Interoperability endpoints
- dmitriypetrov@nslijmedgr.allscriptsdirect.net
Organizations & group practices 6
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.
-
- Gynecologic Oncology Physician
- Philadelphia, PA
- NPI 1235527342
-
- Maternal & Fetal Medicine Physician
- Philadelphia, PA
- NPI 1326436437
-
- Surgical Oncology Physician
- Philadelphia, PA
- NPI 1871981985
-
- General Acute Care Hospital
- Philadelphia, PA
- NPI 1245207521
-
- General Acute Care Hospital
- New Hyde Park, NY
- NPI 1285641514
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- New Hyde Park, NY
- NPI 1285641514
-
- General Acute Care Hospital
- Manhasset, NY
- NPI 1366459570
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1307577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525305600000",
"number": "1265726079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3400 SPRUCE ST",
"address_2": "3 SILVERSTEIN",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044238",
"telephone_number": "215-662-3487",
"fax_number": "215-349-5534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 SPRUCE ST",
"address_2": "3 SILVERSTEIN",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191044238",
"telephone_number": "215-662-3487",
"fax_number": "215-349-5534"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETROV",
"first_name": "DMITRIY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-06-09",
"last_updated": "2018-05-03",
"status": "A"
},
"taxonomies": [
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "PA",
"license": "MD451566",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2018; 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.