Michael Petruska OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

27OA00616700 Issued in NJ

Legal business name

MICHAEL PETRUSKA OD PC

Practice address

1326 Belvidere Rd
Phillipsburg, NJ 08865-2004

Phone

(908) 454-2300

Fax

(908) 454-1661

NPI assigned

Aug 17, 2008

Last updated

May 14, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael Petruska, O. D.NPI 1508970856

Title

President

Phone

(908) 454-2300

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Petruska, O.D.

  • Optometrist
  • Phillipsburg, NJ
  • NPI 1508970856
  Medicare reassignment NPD Authorized official
• James F. Kline, O. D.

  • Optometrist
  • Phillipsburg, NJ
  • NPI 1801975214
  NPD (past)

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

{
    "created_epoch": "1218931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242259200000",
    "number": "1548416910",
    "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": {
        "organization_name": "MICHAEL PETRUSKA OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-17",
        "last_updated": "2009-05-14",
        "status": "A",
        "authorized_official_last_name": "PETRUSKA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "908-454-2300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O. D."
    },
    "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": []
}

• Lisa Mermini, MA, LPC, LCADC
• Julie C. Messenger, MSW, LSW
• Myrlande Metellus, FNP-BC
• Emily Meyers, CRNP
• Michael Nekoranik DO PC
• Olivia Midili
• Isidore Mihalakis, M.D.
• Christine Miller, LSW
• Kayla R Miller, BCBA
• George Mina, DPM

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.