Individual provider Active NPI

Viktor Ivanovich Petrovets, FNP-BC

  • Family Nurse Practitioner
  • Utica, NY
National Provider Identifier
1265745178
Registry record updated Feb 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F336328 Issued in NY
Practice address
417 Trenton Ave
Utica, NY 13502-1613
Phone
(315) 797-5810
Fax
(315) 732-7030
NPI assigned
Jul 20, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2016

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 F336328 NY Primary

Addresses

Primary practice location

417 Trenton Ave
Utica, NY 13502-1613

Mailing address

417 Trenton Ave
Utica, NY 13502-1613
Phone (315) 797-5810

Other identifiers 1

IdentifierTypeStateIssuer
03322525MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20110811000034 NY Practitioner - Nurse Practitioner 3971772898 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MVHS IncGroup PAC ID 2769380252, 330 clinicians

Practice addresses (Care Compare)

1676 Sunset Ave
Utica, NY 13502-5416
Phone (315) 625-6000

417 Trenton Ave
Utica, NY 13502-1613
Phone (315) 797-5810

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.28 of 100Reported as group
Quality
75.06
Promoting interoperability
100
Improvement activities
40
Cost
69.26

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F336328NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
MVHS Inc CurrentSince Feb 1, 2014 Accepting new patients
MVHS Inc CurrentSince Feb 1, 2014 Accepting new patients

Locations

1656 Champlin Ave
New Hartford, NY 13413
Phone (315) 624-6222

417 Trenton Ave
Utica, NY 13502
Phone (315) 732-8800

2209 Genesee St
Utica, NY 13501
Phone (315) 798-8100

1676 Sunset Ave
Utica, NY 13502
Phone (315) 624-5567

Interoperability endpoints

  • Direct secure messaging: vpetrovets@hiemail.healtheconnections.org
  • Direct secure messaging: vpetrovets11511@mvhealthsystem.direct-ci.com

Organizations & group practices 2

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 1

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": "1279584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454457600000",
    "number": "1265745178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 TRENTON AVE",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135021613",
            "telephone_number": "315-797-5810",
            "fax_number": "315-732-7030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "417 TRENTON AVE",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135021613",
            "telephone_number": "315-797-5810",
            "fax_number": "315-732-7030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROVETS",
        "first_name": "VIKTOR",
        "middle_name": "IVANOVICH",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-20",
        "last_updated": "2016-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F336328",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03322525",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

Verify at the official NPI Registry.