Individual provider Active NPI

Jessica Theresa Petros, M.D.

  • Internal Medicine Physician
  • Greenbelt, MD
National Provider Identifier
1528231016
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D88200 Issued in MD
Practice address
7474 Greenway Center Dr
Greenbelt, MD 20770-3504
Phone
(866) 877-7258
Fax
(240) 624-2279
NPI assigned
Apr 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D88200 MD Primary

Addresses

Primary practice location

7474 Greenway Center Dr
Greenbelt, MD 20770-3504

Mailing address

8665 Georgia Ave
Silver Spring, MD 20910-3405
Phone (301) 340-7525

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081209000514 NY Practitioner - Internal MedicinePractitioner - Pediatric Medicine 9638230600 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Healthcare, Inc. Current Accepting new patients
Premier Healthcare, Inc. CurrentSince Aug 15, 2008 Accepting new patients

Locations

3060 E Tremont Ave
Bronx, NY 10461
Phone (718) 239-1790

175 Remsen St
Brooklyn, NY 11201
Phone (718) 303-1300

460 W 34th St
Fl 9
New York, NY 10001
Phone (212) 273-6515

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.

NPI Registry JSON

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

{
    "created_epoch": "1207526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1528231016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8665 GEORGIA AVE",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209103405",
            "telephone_number": "301-340-7525",
            "fax_number": "301-495-0318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7474 GREENWAY CENTER DR",
            "city": "GREENBELT",
            "state": "MD",
            "postal_code": "207703504",
            "telephone_number": "866-877-7258",
            "fax_number": "240-624-2279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROS",
        "first_name": "JESSICA",
        "middle_name": "THERESA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-07",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D88200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenbelt, MD

Sources for this page

Verify at the official NPI Registry.