Active NPI
Peter Allan Petrukitas, ARNP
- Adult Health Nurse Practitioner
- Tacoma, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- AP60396780
- Practice address
- 1901 S Cedar St Ste 301
Tacoma, WA 98405-2302 - Phone
- (253) 572-7320
- NPI assigned
- Nov 13, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | AP60396780 | WA | Primary |
Addresses
Primary practice location
1901 S Cedar St Ste 301
Tacoma, WA 98405-2302
Mailing address
1901 S Cedar St Ste 301
Tacoma, WA 98405-2302
Phone (253) 572-7320
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706
Hospital & facility affiliations
- Tacoma General Allenmore Hospital
- Capital Medical Center
- Summit Pacific Medical Center
- Mason General Hospital & Family of Clinics
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Multicare Health System | Current | Accepting new patients | |
| Multicare Health System | Current | Accepting new patients | |
| Multicare Health System | Current | Accepting new patients | |
| Multicare Health System | Past | Accepting new patients |
Locations
4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590
222 State Ave N
Kent, WA 98030
Phone (253) 372-7680
17700 SE 272nd St
Kent, WA 98042
Phone (253) 372-6500
311 S L St
Tacoma, WA 98405
Phone (253) 403-1444
1901 S Cedar St
Ste 301
Tacoma, WA 98405
Phone (253) 396-4806
Interoperability endpoints
- ppetrukitas123984@direct.multicare.org
Organizations & group practices 4
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.
-
- Neurological Surgery Physician
- Tacoma, WA
- NPI 1497766638
-
- Community/Retail Pharmacy
- Spokane, WA
- NPI 1396594875
-
- Community/Behavioral Health Agency
- Puyallup, WA
- NPI 1700925351
-
- Family Medicine Physician
- Auburn, WA
- NPI 1013969195
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Critical Access Hospital
- Elma, WA
- NPI 1740211028
-
- General Acute Care Hospital
- Tacoma, WA
- NPI 1366556227
-
- General Acute Care Hospital
- Olympia, WA
- NPI 1841258639
-
- Critical Access Hospital
- Shelton, WA
- NPI 1760568752
-
- Foot & Ankle Surgery Podiatrist
- Shelton, WA
- NPI 1437486248
Hospital
-
- Surgery Physician
- Shelton, WA
- NPI 1639339666
Hospital
-
- Ophthalmologic Surgery Clinic/Center
- Shelton, WA
- NPI 1922196609
Hospital
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1384300800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462492800000",
"number": "1396175220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1901 S CEDAR ST STE 301",
"city": "TACOMA",
"state": "WA",
"postal_code": "984052302",
"telephone_number": "253-572-7320"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901 S CEDAR ST STE 301",
"city": "TACOMA",
"state": "WA",
"postal_code": "984052302",
"telephone_number": "253-572-7320"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETRUKITAS",
"first_name": "PETER",
"middle_name": "ALLAN",
"credential": "ARNP",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-11-13",
"last_updated": "2016-05-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "WA",
"license": "AP60396780",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2016; 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.