Robert T. Petruzzo Jr., DO

Primary specialty

Body Imaging PhysicianTaxonomy code 2085B0100X

License

20A4255 Issued in CA

Practice address

4405 Vandever Ave
San Diego, CA 92120-3315

Phone

(619) 528-5000

NPI assigned

Jan 17, 2007

Last updated

Apr 28, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 CA

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

Diagnostic Radiology

Education

Other, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sol Radiology IncGroup PAC ID 1850796681, 66 clinicians

Krishna Das MD IncGroup PAC ID 3971940479, 18 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Desert Valley Hospital Hospital, Victorville, CA, CCN 050709
• Oak Valley Hospital District Hospital, Oakdale, CA, CCN 050067
• Bear Valley Community Hospital Hospital, Big Bear Lake, CA, CCN 051335
• Victor Valley Global Medical Center Hospital, Victorville, CA, CCN 050517
• Mad River Community Hospital Hospital, Arcata, CA, CCN 050028

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Krishna Das MD Inc.

  • Diagnostic Radiology Physician
  • Victorville, CA
  • NPI 1164284196
  Medicare reassignment Care Compare group NPD
• Sol Radiology, Inc.

  • Diagnostic Radiology Physician
  • Victorville, CA
  • NPI 1457928111

  Body Imaging

  Medicare reassignment Care Compare group NPD
• City of Hope Medical Foundation

  dba City of Hope Duarte

  • Hematology & Oncology Physician
  • Duarte, CA
  • NPI 1871886366
  Medicare reassignment NPD
• Megha Nayyar Gupta MD Inc.

  • Diagnostic Radiology Physician
  • Victorville, CA
  • NPI 1669234670
  Medicare reassignment NPD
• Rahul Nayyar MD Inc

  • Diagnostic Radiology Physician
  • Victorville, CA
  • NPI 1518729516
  Medicare reassignment NPD
• Seven Star Hospital Associates Inc.

  dba Seven Star Radiology

  • Diagnostic Radiology Physician
  • Hemet, CA
  • NPI 1043813140
  Medicare reassignment NPD
• Sheridan Radiology Services of Pinellas, Inc.

  • Diagnostic Radiology Physician
  • Fort Lauderdale, FL
  • NPI 1629439658
  NPD
• City of Hope Medical Foundation

  dba City of Hope Newport Beach

  • Hematology & Oncology Physician
  • Newport Beach, CA
  • NPI 1558930859
  NPD (past)
• Pin Point Radiology Practice Group, PA

  • Diagnostic Radiology Physician
  • Hudson, OH
  • NPI 1225263767
  NPD (past)
• Universal Radiology Consultants PC

  • Diagnostic Radiology Physician
  • Warner Robins, GA
  • NPI 1689606188
  NPD (past)

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

• American Hospital Management Corporation

  dba Mad River Community Hospital

  • General Acute Care Hospital
  • Arcata, CA
  • NPI 1518996040
  Care Compare affiliation
• Bear Valley Community Health Care District

  dba Bear Valley Community Hospital

  • Long Term Care Pharmacy
  • Big Bear Lake, CA
  • NPI 1073553756

  Hospital

  Care Compare affiliation
• Desert Valley Hospital, LLC

  dba Desert Valley Hospital

  • General Acute Care Hospital
  • Victorville, CA
  • NPI 1851396576
  Care Compare affiliation
• Oak Valley Hospital District

  dba Oak Valley District Hospital

  • General Acute Care Hospital
  • Oakdale, CA
  • NPI 1346381415
  Care Compare affiliation
• Victor Valley Hospital Acquisition, Inc.

  dba Victor Valley Global Medical Center

  • General Acute Care Hospital
  • Victorville, CA
  • NPI 1679879589
  Care Compare affiliation

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209340800000",
    "number": "1578615936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1153 PINE DR",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "920207248",
            "telephone_number": "000-000-0000",
            "fax_number": "000-000-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4405 VANDEVER AVE",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921203315",
            "telephone_number": "619-528-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRUZZO",
        "first_name": "ROBERT",
        "middle_name": "T.",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2008-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "CA",
            "license": "20A4255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX42550",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emilya Petrosyan
• Brandon Michael Petrovich, MD
• Irina Petrovich
• Dennis John Petrucci, A.T.C.
• Catherine Dare Petruny, DNP
• Tiffany Petrzelka, AMFT
• Taylor Jane Pettek, NP
• Patricia Loy Petterson, PH.D.
• Faye Pettie
• Laura Pettijohn

• Body Imaging Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Body Imaging Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2008; 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.