Zachary Gene Petro, LSAA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CTB-2022-0086 Issued in NM

Practice address

630 Haines Ave NW
Albuquerque, NM 87102-1226

Phone

(505) 268-5611

Fax

(505) 268-5736

NPI assigned

Aug 14, 2022

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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 and National Provider Directory roles.

• Metro Treatment of New Mexico LP

  • Methadone Clinic
  • Albuquerque, NM
  • NPI 1144437294
  NPD (past)
• Metro Treatment of New Mexico LP

  • Methadone Clinic
  • Albuquerque, NM
  • NPI 1710512199
  NPD (past)

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

{
    "created_epoch": "1660435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675296000000",
    "number": "1417685652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 HAINES AVE NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871021226",
            "telephone_number": "505-268-5611",
            "fax_number": "505-268-5736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 HAINES AVE NW",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871021226",
            "telephone_number": "505-268-5611",
            "fax_number": "505-268-5736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRO",
        "first_name": "ZACHARY",
        "middle_name": "GENE",
        "credential": "LSAA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-14",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NM",
            "license": "CTB-2022-0086",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vitaliya Petko
• Oksana Petrechko, DO
• Michael Richard Petrich, PHARM.D.
• Jonathan Valentino Petrillo, MD
• Grace Petro
• Rachel Petroff
• Stuart Pett, MD
• Cathy Anne Petti, MD
• Kali Suzanne Nan Petties, T-CTL0220451
• Angela Pettiford

• Addiction (Substance Use Disorder) Counselor in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Addiction (Substance Use Disorder) Counselor in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.