Individual provider Active NPI

Alexandra Marie Petrie

  • Obstetrics & Gynecology Physician
  • West Allis, WI
National Provider Identifier
1407317456
Registry record updated Oct 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
74485 Issued in WI
Practice address
8905 W Lincoln Ave
West Allis, WI 53227-2468
Phone
(414) 328-8650
NPI assigned
Mar 30, 2019
Last updated
Oct 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 74485 WI Primary

Addresses

Primary practice location

8905 W Lincoln Ave
West Allis, WI 53227-2468

Mailing address

PO Box 735044
Chicago, IL 60673-5044
Phone (414) 328-8650

Other practice location 1

9200 W Wisconsin Ave
Milwaukee, WI 53226-3522
Phone (414) 805-6600

Other identifiers 1

IdentifierTypeStateIssuer
100146051MedicaidWI

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address apetrie379618@direct.myadvocateaurora.org Direct
FHIR URL https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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

Enrollment IDStateProvider typePAC IDDetails
I20230906000487 WI Practitioner - Obstetrics/Gynecology 3072948496 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
Pennsylvania State University College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aurora Advanced Healthcare, Inc.Group PAC ID 3375625833, 1,107 clinicians
Aurora Medical Group, Inc.Group PAC ID 6709794258, 3,764 clinicians

Practice addresses (Care Compare)

14555 W National Ave
Suite 160
New Berlin, WI 53151-4497
Phone (262) 827-2975

8905 W Lincoln Ave
West Allis, WI 53227-2468
Phone (414) 328-8480

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
74485WIMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Advanced Healthcare, Inc. Obstetrics & Gynecology CurrentSince Sep 1, 2024 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Sep 1, 2023 Accepting new patients
Aurora Medical Group, Inc. Obstetrics & Gynecology CurrentSince Sep 1, 2023 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Sep 1, 2024 Accepting new patients
Aurora Medical Group, Inc. Past Accepting new patients

Locations

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

14555 W National Ave
Ste 160
New Berlin, WI 53151
Phone (262) 827-2975

9200 W Wisconsin Ave
Wauwatosa, WI 53226
Phone (414) 259-3000

8905 W Lincoln Ave
West Allis, WI 53227
Phone (414) 328-6000

Interoperability endpoints

  • Direct secure messaging: apetrie379618@direct.myadvocateaurora.org

Organizations & group practices 5

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1553904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698278400000",
    "number": "1407317456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 735044",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606735044",
            "telephone_number": "414-328-8650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8905 W LINCOLN AVE",
            "city": "WEST ALLIS",
            "state": "WI",
            "postal_code": "532272468",
            "telephone_number": "414-328-8650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9200 W Wisconsin Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukee",
            "state": "WI",
            "postal_code": "532263522",
            "country_code": "US",
            "telephone_number": "414-805-6600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETRIE",
        "first_name": "ALEXANDRA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-30",
        "last_updated": "2023-10-26",
        "certification_date": "2023-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WI",
            "license": "74485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100146051",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apetrie379618@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "8905 W Lincoln Ave",
            "city": "West Allis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532272468",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "8905 W Lincoln Ave",
            "city": "West Allis",
            "state": "WI",
            "country_code": "US",
            "postal_code": "532272468",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Allis, WI

Sources for this page

Verify at the official NPI Registry.