Laura Israelian Petras, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

0101252016 Issued in VA

Practice address

632 Broadway PH
New York, NY 10012-2614

Phone

(347) 294-3414

NPI assigned

Apr 28, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

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

State licenses

Practice roles

Locations

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.

• Galileo Medical Group Ga, P.C.

  • Family Medicine Physician
  • New York, NY
  • NPI 1245920305

  GA

  Medicare reassignment NPD

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

{
    "created_epoch": "1240876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673568000000",
    "number": "1477797967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 BLEECKER ST # 151",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100122410",
            "telephone_number": "347-294-3414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 BROADWAY PH",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100122614",
            "telephone_number": "347-294-3414"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1550 Tomcat Blvd",
            "address_2": "Suite 150",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234602218",
            "country_code": "US",
            "telephone_number": "757-953-3933",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2100 Lynnhaven Pkwy Ste 201",
            "address_purpose": "LOCATION",
            "city": "Virginia Beach",
            "state": "VA",
            "postal_code": "234561492",
            "country_code": "US",
            "telephone_number": "757-953-6708",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "620 John Paul Jones Cir",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "VA",
            "postal_code": "237082111",
            "country_code": "US",
            "telephone_number": "757-953-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETRAS",
        "first_name": "LAURA",
        "middle_name": "ISRAELIAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-28",
        "last_updated": "2023-01-13",
        "certification_date": "2023-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "261321",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101252016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "laura.i.petras.ctr@health.mil",
            "affiliation": "Y",
            "affiliationName": "NAVAL MEDICAL CENTER PORTSMOUTH",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "620 John Paul Jones Cir",
            "city": "Portsmouth",
            "state": "VA",
            "country_code": "US",
            "postal_code": "237082111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Carmine Brian Petracca, MD
• Paul Petrakos, DO
• Jamie Petrancosta
• Alexandra Petraru
• Jennifer N Petras, M.D.
• Sara Petrasso, M.A.
• Barbara Judith Petratos, MS DSW LCSW
• Marinos A Petratos, M.D.
• Theodora Niki Petratos, M.D.
• Luiza F Petre, MD

• Family Medicine Physician in New York, NY
• Providers in New York, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2023; 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.