Individual provider Active NPI

Christopher Paul Petrella

  • Physician Assistant
  • Brooklyn, NY
National Provider Identifier
1497517783
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
031415-01 Issued in NY
Practice address
7202 Fort Hamilton Pkwy
Brooklyn, NY 11228-1906
Phone
(929) 491-7700
NPI assigned
Jan 23, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X
Physician Assistant 363A00000X 031415-01 NY Primary

Addresses

Primary practice location

7202 Fort Hamilton Pkwy
Brooklyn, NY 11228-1906

Mailing address

7202 Fort Hamilton Pkwy
Brooklyn, NY 11228-1906
Phone (929) 491-7700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240425001118 NY Practitioner - Physician Assistant 6709226699 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Group practices
The Center for Discovery IncGroup PAC ID 1557250933, 22 clinicians

Practice addresses (Care Compare)

606 Old Route 17
Monticello, NY 12701-7013
Phone (845) 707-8400

Hospital & facility affiliations

  • Garnet Health Medical Center Catskills Hospital, Harris, NY, CCN 330386
  • Garnet Health Medical Center Hospital, Middletown, NY, CCN 330126

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
031415-01NYMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: cpetrella@hiemail.healtheconnections.org

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 3

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": "1705968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1497517783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7202 FORT HAMILTON PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112281906",
            "telephone_number": "929-491-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7202 FORT HAMILTON PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112281906",
            "telephone_number": "929-491-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRELLA",
        "first_name": "CHRISTOPHER",
        "middle_name": "PAUL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-01-23",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "031415-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.