Individual provider Active NPI

Elisabeth Joye Petr, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Waco, TX
National Provider Identifier
1457610933
Registry record updated Jul 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
R1436 Issued in TX
Practice address
405 Londonderry Dr Ste 301
Waco, TX 76712-7922
Phone
(254) 537-6530
NPI assigned
May 3, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X R1436 TX Primary

Addresses

Primary practice location

405 Londonderry Dr Ste 301
Waco, TX 76712-7922

Mailing address

405 Londonderry Dr Ste 301
Waco, TX 76712-7922
Phone (254) 537-6530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20170619000178 TX Practitioner - Endocrinology 3173823895 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Endocrinology
Education
University of Texas Southwestern Medical School at Dallas, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health AllianceGroup PAC ID 6305731068, 119 clinicians

Practice addresses (Care Compare)

301 Richland W Cir
Providence Internal Medicine Clinic
Waco, TX 76712-7932
Phone (254) 537-6200

340 Richland W Cir
Ascension Medical Group Providence
Waco, TX 76712-7919
Phone (254) 537-6050

342 Richland W Cir
Waco, TX 76712-7919
Phone (254) 537-6600

405 Londonderry Dr
Waco, TX 76712-7922

6901 Medical Pkwy
Waco, TX 76712-7910
Phone (254) 751-4000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health Alliance CurrentSince Oct 1, 2020 Accepting new patients
Providence Health Alliance CurrentSince Oct 1, 2020 Accepting new patients

Locations

405 Londonderry Dr
Ste 301
Waco, TX 76712
Phone (241) 741-6333

405 Londonderry Dr
Ste 310
Waco, TX 76712
Phone (254) 399-6000

301 Richland West Cir
Waco, TX 76712
Phone (254) 537-6200

Interoperability endpoints

  • Direct secure messaging: elisabeth.petr.md.1@9635.direct.athenahealth.com

Organizations & group practices 2

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1336003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752710400000",
    "number": "1457610933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 LONDONDERRY DR STE 301",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127922",
            "telephone_number": "254-537-6530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 LONDONDERRY DR STE 301",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767127922",
            "telephone_number": "254-537-6530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETR",
        "first_name": "ELISABETH",
        "middle_name": "JOYE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-03",
        "last_updated": "2025-07-17",
        "certification_date": "2025-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "TX",
            "license": "R1436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waco, TX

Sources for this page

Verify at the official NPI Registry.