Individual provider Active NPI

Brian D Petrarca, PA

  • Physician Assistant
  • Greensboro, NC
National Provider Identifier
1457323867
Registry record updated Aug 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
102081 Issued in NC
Practice address
1211 Virginia St
Greensboro, NC 27401-1313
Phone
(336) 275-0927
NPI assigned
Feb 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 102081 NC Primary

Addresses

Primary practice location

1211 Virginia St
Greensboro, NC 27401-1313

Mailing address

300 W Northwood St
Greensboro, NC 27401-1324
Phone (336) 275-0927

Other practice location 1

300 W Northwood St
Greensboro, NC 27401-1324
Phone (336) 235-4344

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bpetrarca4445@direct.conehealth.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1138838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629849600000",
    "number": "1457323867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W NORTHWOOD ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011324",
            "telephone_number": "336-275-0927",
            "fax_number": "336-275-4834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 VIRGINIA ST",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274011313",
            "telephone_number": "336-275-0927"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 W Northwood St",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "NC",
            "postal_code": "274011324",
            "country_code": "US",
            "telephone_number": "336-235-4344",
            "fax_number": "336-275-4834",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETRARCA",
        "first_name": "BRIAN",
        "middle_name": "D",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-02",
        "last_updated": "2021-08-25",
        "certification_date": "2021-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "102081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bpetrarca4445@direct.conehealth.com",
            "affiliation": "N",
            "endpointDescription": "cone health direct address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1211 Virginia St",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274011313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Greensboro, NC

Sources for this page

Verify at the official NPI Registry.