Maria M. Petrick, M.D.

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

C132754 Issued in CA

Practice address

130 Stony Point Rd
Suite E
Santa Rosa, CA 95401-4120

Phone

(707) 525-0211

Fax

(707) 525-0491

NPI assigned

Jul 11, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 8

Other names 1

• Maria M. Palmieri Former name

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

Specialty

Allergy/Immunology

Education

University of Tennessee, HSC, College of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Allergy and Asthma Adult and Pediatric Medical Group of the Redwoods IGroup PAC ID 8921084773, 3 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

21.51 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

71.71

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GEECAD/Endpoint/GEECAD

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.

• Allergy & Asthma Adult & Pediatric Medical Group of the Redwoods Inc

  • Allergy & Immunology Physician
  • Santa Rosa, CA
  • NPI 1730257932
  Medicare reassignment Care Compare group NPD
• Pediatric Wellness Group

  • Pediatrics Physician
  • Redwood City, CA
  • NPI 1679871057
  NPD (past)
• SRM Alliance Hospital Services

  • Skilled Nursing Facility
  • Petaluma, CA
  • NPI 1770703886
  NPD (past)
• St. Joseph Health Northern California, LLC

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1134152549
  NPD (past)
• Sutter Bay Hospitals

  • General Acute Care Hospital
  • Santa Rosa, CA
  • NPI 1740413798
  NPD (past)
• Healthcare Physicians of Southern Illinois, PC

  • Family Medicine Physician
  • Belleville, IL
  • NPI 1023034618
  NPD (past)
• Memorial Hospital

  • Occupational Therapist
  • Belleville, IL
  • NPI 1578604443
  NPD (past)

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1447632000000",
    "number": "1396743605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 STONY POINT RD",
            "address_2": "SUITE E",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014120",
            "telephone_number": "707-525-0211",
            "fax_number": "707-525-0491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 STONY POINT RD",
            "address_2": "SUITE E",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954014120",
            "telephone_number": "707-525-0211",
            "fax_number": "707-525-0491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRICK",
        "first_name": "MARIA",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-11",
        "last_updated": "2015-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "KY",
            "license": "40808",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "IN",
            "license": "01063403A",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "CA",
            "license": "C132754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM PIN",
            "identifier": "000000514027",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIN NUMBER",
            "identifier": "HKRAA3F00",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00411953",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "ZZZ95243Z",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200855600",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100013590",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "50015240",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0061440",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIA",
            "last_name": "PALMIERI",
            "middle_name": "M.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jill Peterson
• Kimberly Peterson, MA, MFTI
• Scott Paul Peterson, M.D.
• Sherrill Diane Petherbridge, FNP
• Parker William Petray
• Katherine Pettibone, DPM
• Jill Pettit, CCC-SLP
• Alice D Petty-Hannum, MFT
• Joseph Michael Petzel, M.F.T.
• Michael Leonce Pezold, M.D.

• Allergy & Immunology Physician in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Allergy & Immunology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2015; 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.

Verify at the official NPI Registry.