Active NPI
David Petrella, M.D.
- Diagnostic Ultrasound Physician
- Mt Pleasant, MI
National Provider Identifier
1407872922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Ultrasound Physician
- License
- 4301040434
- Practice address
- 211 S Crapo St
Suite F
Mt Pleasant, MI 48858-2961 - Phone
- (989) 773-2081
- Fax
- (989) 773-3418
- NPI assigned
- Jul 15, 2006
- Last updated
- Sep 11, 2025
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nuclear Radiology Physician | 2085N0904X | 4301040434 | MI | |
| Diagnostic Radiology Physician | 2085R0202X | 4301040434 | MI | |
| Vascular & Interventional Radiology Physician | 2085R0204X | 4301040434 | MI | |
| Diagnostic Ultrasound Physician | 2085U0001X | 4301040434 | MI | Primary |
Addresses
Primary practice location
211 S Crapo St
Suite F
Mt Pleasant, MI 48858-2961
Mailing address
PO Box 10
Mt Pleasant, MI 48804-0010
Phone (989) 773-2081
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301040434 | MI | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mid Michigan Radiology Associates, P.C. | Nuclear Radiology | Past | Accepting new patients |
| Mid-Michigan Radiology Associates, PC | Diagnostic Radiology | Past | Accepting new patients |
| Isomm LLC | Diagnostic Radiology | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Diagnostic Radiology Physician
- Mt Pleasant, MI
- NPI 1366541138
Nuclear Radiology
-
- Diagnostic Radiology Physician
- Alma, MI
- NPI 1770740581
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1407872922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 10",
"city": "MT PLEASANT",
"state": "MI",
"postal_code": "488040010",
"telephone_number": "989-773-2081",
"fax_number": "989-773-3418"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "211 S CRAPO ST",
"address_2": "SUITE F",
"city": "MT PLEASANT",
"state": "MI",
"postal_code": "488582961",
"telephone_number": "989-773-2081",
"fax_number": "989-773-3418"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETRELLA",
"first_name": "DAVID",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-15",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "2085N0904X",
"taxonomy_group": "",
"desc": "Radiology, Nuclear Radiology",
"state": "MI",
"license": "4301040434",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MI",
"license": "4301040434",
"primary": false
},
{
"code": "2085R0204X",
"taxonomy_group": "",
"desc": "Radiology, Vascular & Interventional Radiology",
"state": "MI",
"license": "4301040434",
"primary": false
},
{
"code": "2085U0001X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Ultrasound",
"state": "MI",
"license": "4301040434",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Mt Pleasant, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.