Mandy Petry, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.0004121 Issued in CO

Practice address

8101 E Lowry Blvd Ste 230
Denver, CO 80230-7195

Phone

(303) 344-9090

Fax

(303) 344-1922

NPI assigned

Oct 23, 2014

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

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

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Spineone, PLLCGroup PAC ID 6406877521, 10 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Spineone, PLLC

  • Specialist
  • Lone Tree, CO
  • NPI 1760604409
  Medicare reassignment Care Compare group
• Orthopedic Centers of Colorado, LLC

  dba Perioperative Medicine Care Center

  • Orthopaedic Surgery Physician
  • Denver, CO
  • NPI 1801339502

  Physician Assistant

  Medicare reassignment NPD
• American Current Care PA

  dba Concentra Urgent Care

  • Urgent Care Clinic/Center
  • Addison, TX
  • NPI 1811178213

  CO

  Medicare reassignment NPD
• Meadows Family Medical Center Inc

  • Family Medicine Physician
  • Denver, CO
  • NPI 1962440412
  Medicare reassignment
• Orthopedic Centers of Colorado, LLC

  • Orthopaedic Surgery Physician
  • Superior, CO
  • NPI 1336870856

  Physician Assistant

  NPD
• American Current Care P.a.

  dba Concentra Urgent Care

  • Urgent Care Clinic/Center
  • Beaumont, TX
  • NPI 1376356568
  NPD

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

{
    "created_epoch": "1414022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1578968236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8101 E LOWRY BLVD STE 230",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802307195",
            "telephone_number": "303-344-9090",
            "fax_number": "303-344-1922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8101 E LOWRY BLVD STE 230",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802307195",
            "telephone_number": "303-344-9090",
            "fax_number": "303-344-1922"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "24281 E Roxbury Cir",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800164109",
            "country_code": "US",
            "telephone_number": "337-384-5041",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24281 E Roxbury Cir",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "CO",
            "postal_code": "800164109",
            "country_code": "US",
            "telephone_number": "337-384-5041",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETRY",
        "first_name": "MANDY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-23",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CO",
            "license": "PA.0004121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mia L Petrocelli
• Melissa Hope Petros, RN
• Kristina Ann Petrosino, RDH
• Mary Elaine Petrucci
• Erin S Petrush, OTD, OTR/L
• Renate Petters
• Michael Darby Pettersen, MD
• Kelly Joy Pettijohn, M.D.
• Maxwell Ruskin Pettijohn, O.D.
• David Pettit, MD

• Physician Assistant in Denver, CO
• Providers in Denver, CO by specialty
• Physician Assistant in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.