Individual provider Active NPI

Beverley Petrie, M.D.

  • Colon & Rectal Surgery Physician
  • Torrance, CA
National Provider Identifier
1275544116
Registry record updated Sep 25, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X
License
A55817 Issued in CA
Practice address
21840 Normandie Ave
Torrance, CA 90502-2047
Phone
(310) 222-5015
Fax
(310) 222-5027
NPI assigned
Aug 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Colon & Rectal Surgery Physician 208C00000X A55817 CA Primary

Addresses

Primary practice location

21840 Normandie Ave
Torrance, CA 90502-2047

Mailing address

21840 Normandie Ave
Torrance, CA 90502-2047
Phone (310) 222-5015

Other identifiers 1

IdentifierTypeStateIssuer
00A558170MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040622001267 CA Practitioner - Colorectal Surgery (Proctology) 6103801261 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
County of Los Angeles CurrentSince Jul 16, 2004 Accepting new patients
County of Los Angeles CurrentSince Jul 16, 2004 Accepting new patients
Harbor-UCLA Medical Foundation, Inc Past Accepting new patients

Locations

1000 S Fremont Ave
Unit 9
Alhambra, CA 91803

1000 W Carson St
Torrance, CA 90502
Phone (310) 222-3501

1000 W Carson St
#480
Torrance, CA 90502
Phone (310) 222-5026

1000 W Carson St
#25
Torrance, CA 90502
Phone (424) 306-8089

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.

NPI Registry JSON

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380067200000",
    "number": "1275544116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21840 NORMANDIE AVE",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905022047",
            "telephone_number": "310-222-5015",
            "fax_number": "310-222-5027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21840 NORMANDIE AVE",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905022047",
            "telephone_number": "310-222-5015",
            "fax_number": "310-222-5027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRIE",
        "first_name": "BEVERLEY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2013-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "CA",
            "license": "A55817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A558170",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Torrance, CA

Sources for this page

Verify at the official NPI Registry.