Mark J Petrini, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

230299 Issued in NY

Practice address

118 W 79TH St
Suite 1a
New York, NY 10024-6445

Phone

(212) 787-0519

Fax

(212) 305-4724

NPI assigned

Jul 11, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Feb 24, 2016 through Feb 24, 2028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Trustees of Columbia University in Department of Psychiatry

  • Psychiatry Physician
  • New York, NY
  • NPI 1619911526
  NPD (past)

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366477085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 W 79TH ST",
            "address_2": "SUITE 1A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100246445",
            "telephone_number": "212-787-0519",
            "fax_number": "212-305-4724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 W 79TH ST",
            "address_2": "SUITE 1A",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100246445",
            "telephone_number": "212-787-0519",
            "fax_number": "212-305-4724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRINI",
        "first_name": "MARK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "230299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alice Petrikovsky
• Christopher Michael Petrilli, MD
• Sabrina Petrillo, CRNA
• Geralyn Mary Petrilyak, P.T.
• Christine Petrin, MD, MPH
• Monica A Petrisko, NP
• Emily Petrocca, NP
• Irene Petrocelli
• Robert Daniel Petrocelli, M.D.
• Linda Petroff, M.D.

• Psychiatry Physician in New York, NY
• Providers in New York, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.