James G Petros, M.D.

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

48543 Issued in MA

Practice address

830 Harrison Avenue
Moakley Suite 2100
Boston, MA 02118

Phone

(617) 414-8054

Fax

(617) 414-8055

NPI assigned

Apr 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456704000000",
    "number": "1457313009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 MORTON ST",
            "address_2": "DOB 503",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021303735",
            "telephone_number": "617-971-3568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "830 HARRISON AVENUE",
            "address_2": "MOAKLEY SUITE 2100",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118",
            "telephone_number": "617-414-8054",
            "fax_number": "617-414-8055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROS",
        "first_name": "JAMES",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-06",
        "last_updated": "2016-02-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "48543",
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "MA",
            "license": "48543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110053342A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Madalyn Petrillo, MD
• Desire Petrin
• Fabio Petrocca, MD
• Anya Petrof, DMD
• Brittany Alexandra Petros, MD, PHD
• Sharon Petroules, PA-C
• Sanja Petrovic-Stojkovic, M.D.
• Lea Petrovic
• Alex John Petruska Jr., PT
• Stephanie Hope Petruzzi, LICSW

• Colon & Rectal Surgery Physician in Boston, MA
• Providers in Boston, MA by specialty
• Colon & Rectal Surgery Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2016; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.