Olivia Petrasek, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA065871 Issued in PA

Practice address

800 Washington Ave
Philadelphia, PA 19147-4717

Phone

(215) 339-5100

NPI assigned

Sep 10, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: olivia.petrasekpac.p1@direct.gpha.nextgenshare.com

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.

• Greater Philadelphia Health Action Inc.

  dba GPHA Woodland Ave. Behavioral Healthcare

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1205140902
  Medicare reassignment
• Greater Philadelphia Health Action, Inc.

  • Federally Qualified Health Center (FQHC)
  • Philadelphia, PA
  • NPI 1275151607
  NPD

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

{
    "created_epoch": "1725926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727222400000",
    "number": "1558197350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 S 31ST ST FL 2",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191463506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191474717",
            "telephone_number": "215-339-5100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRASEK",
        "first_name": "OLIVIA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-10",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA065871",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA065871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary Petner, PA-C
• Daria Grazia Petraglia, MSPT
• Ella Petranto
• Gyula Michael Petranyi, MD
• Lauren Petrarca
• Petrelli Chiropractic & Rehabilitation, Inc.
• Vincent Petrelli, D.C.
• Louis Daniel Petrellis, DO
• Matteo Petrera, MD
• Patrick Petrera

• Medical Physician Assistant in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.