Zinoviya Petryshyn, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

25MP00290700 Issued in NJ

Practice address

347 Mount Pleasant Ave
West Orange, NJ 07052-2744

Phone

(973) 571-2121

NPI assigned

Oct 1, 2012

Last updated

Sep 25, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Skin and Laser Center of NJ LLCGroup PAC ID 1951681378, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Skin & Laser Center of NJ, LLC

  • Dermatology Physician
  • Ramsey, NJ
  • NPI 1518310366
  Medicare reassignment Care Compare group
• Advanced Dermatology of New Jersey PC

  • Procedural Dermatology Physician
  • Ridgewood, NJ
  • NPI 1225362783
  Medicare reassignment
• The Dermatology Group

  • Dermatology Physician
  • West Orange, NJ
  • NPI 1962428474
  NPD (past)

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

{
    "created_epoch": "1349049600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380067200000",
    "number": "1417208364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 CENTER ST",
            "city": "CLIFTON",
            "state": "NJ",
            "postal_code": "070113901",
            "telephone_number": "201-725-4963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "347 MOUNT PLEASANT AVE",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070522744",
            "telephone_number": "973-571-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRYSHYN",
        "first_name": "ZINOVIYA",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-01",
        "last_updated": "2013-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00290700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph A Persico, DPT
• Kevin Bruce Persily, DDS
• Personal Care Adult Medicine, PC
• Personal Plastic Surgery LLC
• Javicia N Peterson-Cole
• Michael Peysaknov, PT, DPT
• Kate Gruenwald Pfeifer, LCSW
• Geoffrey A Philhower, BCBA
• Lynn N. Philippe
• Salomon Philippe

• Physician Assistant in West Orange, NJ
• Providers in West Orange, NJ by specialty
• Physician Assistant in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2013; 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.