Michael Petruska, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

27OA00616700 Issued in NJ

Practice address

1326 Belvidere Rd
Phillipsburg, NJ 08865-2004

Phone

(908) 454-2300

Fax

(908) 454-1661

NPI assigned

Aug 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Pennsylvania College of Optometry, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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.

• Michael Petruska OD PC

  • Optometrist
  • Phillipsburg, NJ
  • NPI 1548416910
  Medicare reassignment NPD Authorized official
• Michael Petruska OD PC

  • Optometrist
  • Richmond, VA
  • NPI 1124179494
  NPD (past) Authorized official
• James F Kline

  • Eyewear Supplier
  • Phillipsburg, NJ
  • NPI 1265693303
  NPD (past)

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

{
    "created_epoch": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242259200000",
    "number": "1508970856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1326 BELVIDERE RD",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088652004",
            "telephone_number": "908-454-2300",
            "fax_number": "908-454-1661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1326 BELVIDERE RD",
            "city": "PHILLIPSBURG",
            "state": "NJ",
            "postal_code": "088652004",
            "telephone_number": "908-454-2300",
            "fax_number": "908-454-1661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRUSKA",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2009-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NJ",
            "license": "27OA00616700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0180025",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Paulmart Pharmacy LLC
• Laura J Payne, RD
• Noelle Dawn Pellegrino
• People Helping People in Need
• Personal Discoveries
• Elza Pevzner, DO
• Phillipsburg Dental Studio PC
• Phillipsburg Endodontics
• Phillipsburg School District
• Karen Elise Piergies, O.T.R.

• Optometrist in Phillipsburg, NJ
• Providers in Phillipsburg, NJ by specialty
• Optometrist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2009; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.