Individual provider Active NPI

Christie Petrenko, PH.D.

  • Psychologist
  • Rochester, NY
National Provider Identifier
1326409020
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
018988 Issued in NY
Practice address
187 Edinburgh St
Rochester, NY 14608-2415
Phone
(585) 275-2991
NPI assigned
Mar 9, 2016
Last updated
Jun 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 18988 NY
Psychologist 103T00000X 018988 NY Primary

Addresses

Primary practice location

187 Edinburgh St
Rochester, NY 14608-2415

Mailing address

187 Edinburgh St
Rochester, NY 14608-2415
Phone (585) 275-2991

Other names 1

  • Christie McGee Former name

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address cpetrenko107926@direct.urmc.rochester.edu Direct
Direct Messaging Address cpetrenko107926@direct.urmc.rochester.edu Direct

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: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170206000776 NY Practitioner - Clinical Psychologist 8921381526 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
18988NYMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Pediatric Development Clinic CurrentSince Jan 15, 2017 Accepting new patients

Locations

187 Edinburgh St
Rochester, NY 14608
Phone (585) 275-2991

601 Elmwood Ave
Rochester, NY 14642
Phone (585) 275-9555

Interoperability endpoints

  • Direct secure messaging: cpetrenko107926@direct.urmc.rochester.edu

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1457481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1326409020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 EDINBURGH ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146082415",
            "telephone_number": "585-275-2991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 EDINBURGH ST",
            "city": "ROCHESTER",
            "state": "NY",
            "postal_code": "146082415",
            "telephone_number": "585-275-2991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRENKO",
        "first_name": "CHRISTIE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-09",
        "last_updated": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "18988",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NY",
            "license": "018988",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cpetrenko107926@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cpetrenko107926@direct.urmc.rochester.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "OTHER",
            "address_1": "601 Elmwood Ave",
            "city": "Rochester",
            "state": "NY",
            "country_code": "US",
            "postal_code": "146420001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "CHRISTIE",
            "last_name": "MCGEE",
            "credential": "PH.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rochester, NY

Sources for this page

Verify at the official NPI Registry.