Ernestine R Petty, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

G71691 Issued in CA

Practice address

1300 N Vermont Ave
Los Angeles, CA 90027-6098

Phone

(213) 413-3000

Fax

(323) 666-2939

NPI assigned

Feb 13, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Anesthesiology

Education

University of Minnesota Medical School, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Palm Springs Anesthesia Services PCGroup PAC ID 6406049592, 90 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Mary Medical Center Hospital, Long Beach, CA, CCN 050191

Merit-based Incentive Payment System (MIPS)

Final score

84.5 of 100Reported as group

Quality

70

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Palm Springs Anesthesia Services, PC

  • Anesthesiology Physician
  • San Bernardino, CA
  • NPI 1083928501
  Medicare reassignment Care Compare group NPD
• Alameda Health System

  • Surgery Physician
  • Oakland, CA
  • NPI 1740332931
  Medicare reassignment NPD
• HP Anesthesia Inc

  • Anesthesiology Physician
  • Los Angeles, CA
  • NPI 1992133474
  Medicare reassignment NPD
• VP Anesthesia Partners, Inc

  • Anesthesiology Physician
  • Van Nuys, CA
  • NPI 1518694173
  Medicare reassignment NPD
• Alameda Health System

  • Federally Qualified Health Center (FQHC)
  • Newark, CA
  • NPI 1497956288
  NPD
• Trusted Anesthesia Partners, Inc.

  • Anesthesiology Physician
  • Los Angeles, CA
  • NPI 1174143473
  NPD
• Health Alliance Socal, Inc

  • Psychiatry Physician
  • Inglewood, CA
  • NPI 1184343055
  NPD (past)

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

• Dignity Health

  • General Acute Care Hospital
  • Long Beach, CA
  • NPI 1194840421
  Care Compare affiliation

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534464000000",
    "number": "1275675613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N TUSTIN AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053807",
            "telephone_number": "714-347-1000",
            "fax_number": "714-647-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N VERMONT AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900276098",
            "telephone_number": "213-413-3000",
            "fax_number": "323-666-2939"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1411 E 31st St",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946021018",
            "country_code": "US",
            "telephone_number": "510-535-7573",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1411 E 31st St",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946021018",
            "country_code": "US",
            "telephone_number": "510-535-7573",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETTY",
        "first_name": "ERNESTINE",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-13",
        "last_updated": "2018-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "G71691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G716910",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jerell Akeem Pettway
• Kristofer Kedar Pettway
• Tyree Pettway
• Jasmine Petty-Davidson
• Noelle Caron Petty-Marchand
• Jadah Marie Sun Petty, PH.D.
• Jennifer Petty
• Rosalyn June Petty, OTR L
• Giselle Maria Petzinger, M.D.
• Gary Pevnick, PT

• Anesthesiology Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Anesthesiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.

Verify at the official NPI Registry.