Mark Lewis Petrarca, D.O.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

16048 Issued in NH

Practice address

455 Toll Gate Rd
Warwick, RI 02886-2759

Phone

(401) 737-7010

Fax

(401) 453-7597

NPI assigned

Jul 10, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NH

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

Specialty

Emergency Medicine

Education

University of New England, College of Osteo Medicine, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Elliot Professional ServicesGroup PAC ID 6103727920, 429 clinicians

St. Joseph Hospital of Nashua NHGroup PAC ID 2062455611, 271 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elliot Hospital Hospital, Manchester, NH, CCN 300012
• St Joseph Hospital Hospital, Nashua, NH, CCN 300011

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mpetrarca1371837@direct.bsmhealth.org

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.

• Elliot Professional Services

  • Internal Medicine Physician
  • Manchester, NH
  • NPI 1285627935

  Emergency Medicine

  Medicare reassignment Care Compare group NPD
• St Joseph Hospital of Nashua NH

  • General Acute Care Hospital
  • Nashua, NH
  • NPI 1093787384
  Medicare reassignment Care Compare group NPD
• St Joseph Hospital of Nashua NH

  • Urgent Care Clinic/Center
  • Milford, NH
  • NPI 1437758679
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Elliot Hospital of the City of Manchester

  • General Acute Care Hospital
  • Manchester, NH
  • NPI 1902996028
  Care Compare affiliation
• St Joseph Hospital of Nashua NH

  • General Acute Care Hospital
  • Nashua, NH
  • NPI 1093787384
  Care Compare affiliation
• St Joseph Hospital of Nashua NH

  • Urgent Care Clinic/Center
  • Milford, NH
  • NPI 1437758679

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1247184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667174400000",
    "number": "1548499668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 TOLL GATE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862759",
            "telephone_number": "401-737-7010",
            "fax_number": "401-453-7597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 TOLL GATE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028862759",
            "telephone_number": "401-737-7010",
            "fax_number": "401-453-7597"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "172 Kinsley St",
            "address_purpose": "LOCATION",
            "city": "Nashua",
            "state": "NH",
            "postal_code": "030603648",
            "country_code": "US",
            "telephone_number": "603-882-3000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETRARCA",
        "first_name": "MARK",
        "middle_name": "LEWIS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-10",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "RI",
            "license": "LP01618",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NH",
            "license": "16048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mpetrarca1371837@direct.bsmhealth.org",
            "affiliation": "N",
            "address_1": "172 Kinsley St",
            "city": "Nashua",
            "state": "NH",
            "country_code": "US",
            "postal_code": "030603648",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Perspectives Corporation
• Katherine Marie Pescosolido, PHD, LMHC
• Julia Peterson, DPT
• Meagan Peterson, LMFT
• Amanda Petrarca, PHARMD
• Michael Anthony Petrarca, LMHC
• Chantele Petrocelli, LMHC
• Petteruti Family Practice Inc
• Shannon Petteruti, NP-C
• Kaitlin M Petty

• Emergency Medicine Physician in Warwick, RI
• Providers in Warwick, RI by specialty
• Emergency Medicine Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; 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.