Individual provider Active NPI

Linda Petroff, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • New York, NY
National Provider Identifier
1306043195
Registry record updated May 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
239571 Issued in NY
Practice address
1275 York Ave
Department of Pathology, Mskcc
New York, NY 10021-6007
Phone
(212) 639-5914
NPI assigned
Jun 27, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 239571 NY Primary

Addresses

Primary practice location

1275 York Ave
Department of Pathology, Mskcc
New York, NY 10021-6007

Mailing address

5360 Jackson Dr
Ste 218D
La Mesa, CA 91942-6004

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
I20080722000247 CA Practitioner - Pathology 2062513542 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valley Pathology Medical Associates IncGroup PAC ID 1355324377, 6 clinicians

Practice addresses (Care Compare)

15615 Pomerado Rd
Poway, CA 92064-2405
Phone (858) 613-4744

2185 Citracado Pkwy
Escondido, CA 92029-4159
Phone (442) 281-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
239571NYMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Valley Pathology Medical Associates Inc Anatomic Pathology & Clinical Pathology CurrentSince Jul 1, 2008 Accepting new patients
MSK-Guttman Diagnostic Center Past Accepting new patients

Locations

2185 Citracado Pkwy
Escondido, CA 92029
Phone (442) 281-5000

15615 Pomerado Rd
Poway, CA 92064
Phone (858) 613-4000

5700 Southwyck Blvd
Toledo, OH 43614

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 2

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": "1182902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589155200000",
    "number": "1306043195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5360 JACKSON DR",
            "address_2": "STE 218D",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919426004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 YORK AVE",
            "address_2": "DEPARTMENT OF PATHOLOGY, MSKCC",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100216007",
            "telephone_number": "212-639-5914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROFF",
        "first_name": "LINDA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-27",
        "last_updated": "2020-05-11",
        "certification_date": "2020-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "239571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.