Individual provider Active NPI

Aaron Petrarca

  • Peer Specialist
  • Gresham, OR
National Provider Identifier
1508742719
Registry record updated Aug 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Peer SpecialistTaxonomy code 175T00000X
Practice address
1217 NE Burnside Rd Ste 701
Gresham, OR 97030-5770
Phone
(503) 740-1971
NPI assigned
Aug 13, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Peer Specialist 175T00000X Primary

Addresses

Primary practice location

1217 NE Burnside Rd Ste 701
Gresham, OR 97030-5770

Mailing address

1217 NE Burnside Rd Ste 701
Gresham, OR 97030-5770
Phone (503) 740-1971

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1755043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755043200000",
    "number": "1508742719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 NE BURNSIDE RD STE 701",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970305770",
            "telephone_number": "503-740-1971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1217 NE BURNSIDE RD STE 701",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970305770",
            "telephone_number": "503-740-1971"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRARCA",
        "first_name": "AARON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-13",
        "last_updated": "2025-08-13",
        "certification_date": "2025-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gresham, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.