Kathleen Pitterle Petrick, D.O.

Primary specialty

Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X

License

C2-0012722 Issued in DE

Practice address

1600 Rockland Road
Wilmington, DE 19803

Phone

(302) 651-4500

Fax

(302) 651-4543

NPI assigned

May 25, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Kathleen Marie Pitterle Former name

Medicare fee-for-service enrollment

Enrolled in NJ, DE2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kpitterle73762@direct.nemours.org

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.

• The Nemours Foundation

  • Multi-Specialty Clinic/Center
  • Wilmington, DE
  • NPI 1366594699

  Developmental - Behavioral Pediatrics

  Medicare reassignment NPD
• Nemours New Jersey Physician Practice, P.C.

  • Pediatrics Physician
  • Deptford, NJ
  • NPI 1265874713
  Medicare reassignment NPD
• The Nemours Foundation

  • Children's Hospital
  • Wilmington, DE
  • NPI 1467505073
  NPD
• The Nemours Foundation

  • Multi-Specialty Clinic/Center
  • Jacksonville, FL
  • NPI 1265585806
  NPD (past)

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

{
    "created_epoch": "1306281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731715200000",
    "number": "1396038154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 ROCKLAND ROAD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "19803",
            "telephone_number": "302-651-4500",
            "fax_number": "302-651-4543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 ROCKLAND ROAD",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "19803",
            "telephone_number": "302-651-4500",
            "fax_number": "302-651-4543"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 Rockland Rd Ste 302",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "DE",
            "postal_code": "198033648",
            "country_code": "US",
            "telephone_number": "302-651-4200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 Washington St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021111552",
            "country_code": "US",
            "telephone_number": "617-636-7242",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Nemours NJ Physician Practice P.C., Deptford",
            "address_2": "1280 Almonesson Road",
            "address_purpose": "LOCATION",
            "city": "Deptford",
            "state": "NJ",
            "postal_code": "080965502",
            "country_code": "US",
            "telephone_number": "856-345-1401",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "800 Washington St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021111552",
            "country_code": "US",
            "telephone_number": "617-636-7242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETRICK",
        "first_name": "KATHLEEN",
        "middle_name": "PITTERLE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-05-25",
        "last_updated": "2024-11-16",
        "certification_date": "2024-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "262292",
            "primary": false
        },
        {
            "code": "2080P0006X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": "DE",
            "license": "C2-0012722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "PITTERLE",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "DO",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Michael B Peters, M.D.
• Teresa Michelle Peters, PA-C
• -Julie Frances Peterson, D.M.D.
• Morris Peterzell, D.O.
• Nancy F Petit, M.D.
• Maria Eugenia Petrini, MD
• Kimberly B Petruccelli, PHARMD,MBA
• Matthew Petruccelli II, PT, DPT, SCS, OCS
• Douglas Pettiford
• Keith Pettiford

• Developmental - Behavioral Pediatrics Physician in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Developmental - Behavioral Pediatrics Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.