NPIMap

Individual provider Active NPI

Michael Petrides

  • Nuclear Radiology Physician
  • Philadelphia, PA
National Provider Identifier
1609221969
Registry record updated Sep 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Radiology PhysicianTaxonomy code 2085N0904X
License
MD483462 Issued in PA
Practice address
3400 Spruce Street
1 Silverstein, Suite 130
Philadelphia, PA 19104
Phone
(215) 662-6918
Fax
(215) 662-2664
NPI assigned
Apr 25, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Radiology Physician 2085N0904X MD483462 PA Primary
Diagnostic Radiology Physician 2085R0202X MD483462 PA

Addresses

Primary practice location

3400 Spruce Street
1 Silverstein, Suite 130
Philadelphia, PA 19104

Mailing address

3400 Spruce St
Philadelphia, PA 19104-4238
Phone (215) 662-6918

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, WA, PA3 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20220816001938 UT Practitioner - Diagnostic Radiology 6406140987 Reassigns benefits to 9 organizations
I20221024002142 WA Practitioner - Diagnostic Radiology 6406140987 Reassigns benefits to 2 organizations
I20240521001902 PA Practitioner - Diagnostic Radiology 6406140987 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Medical University of South Carolina College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pet-CT Imaging at Swedish Cancer Institute LLCGroup PAC ID 5092736884, 14 clinicians
Swedish Health ServicesGroup PAC ID 3173433067, 156 clinicians
Colorado Imaging Associates P CGroup PAC ID 6800880055, 61 clinicians
Radia Oregon Radiology Medical Group LLCGroup PAC ID 2961852637, 122 clinicians
Medford Radiological Group PCGroup PAC ID 2062303324, 91 clinicians
Evergreen Radia LLCGroup PAC ID 4587568076, 116 clinicians
Swedish Radia Imaging Center at Edmonds LLCGroup PAC ID 5496778292, 115 clinicians
Radia California Radiology Medical Group IncGroup PAC ID 8921465998, 134 clinicians
Radia Inc P SGroup PAC ID 9931012812, 275 clinicians

Practice addresses (Care Compare)

1221 Madison St
Suite 150
Seattle, WA 98104-1385
Phone (206) 215-6487

13020 Meridian Ave S
Everett, WA 98208-6468
Phone (425) 357-3960

2219 Manordale Dr
Export, PA 15632-8962
Phone (303) 223-4459

2936 E Ashwood LN
Saint George, UT 84790-2690
Phone (425) 563-1500

414 E 4235
Washington, UT 84780-1767
Phone (541) 618-5800

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MT223806PAMDNuclear Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Redwood Radiology Group Inc CurrentSince Jan 20, 2023 Accepting new patients
Radia California Radiology Medical Group Inc CurrentSince Jun 1, 2023 Accepting new patients
Swedish Radia Imaging Center at Edmonds LLC CurrentSince Aug 10, 2022 Accepting new patients
Radia Inc P S CurrentSince Aug 10, 2022 Accepting new patients
Radia Imaging Center Holdings LLC CurrentSince Aug 10, 2022 Accepting new patients
Medford Radiological Group, PC CurrentSince Dec 6, 2022 Accepting new patients
South Sound Radiologists Inc P S CurrentSince Aug 10, 2022 Accepting new patients
Pet-CT Imaging at Swedish Cancer Institute LLC Nuclear Radiology CurrentSince Feb 1, 2023 Accepting new patients
Radia Oregon Radiology Medical Group LLC CurrentSince Jan 1, 2024 Accepting new patients
Evergreen Radia LLC CurrentSince Aug 10, 2022 Accepting new patients
Swedish Health Services CurrentSince Aug 5, 2022 Accepting new patients
Swedish Health Services CurrentSince Aug 5, 2022 Accepting new patients

Locations

400 N McDowell Blvd
Petaluma, CA 94954
Phone (707) 778-1111

19950 Rinaldi St
Ste 101B
Porter Ranch, CA 91326
Phone (818) 496-7517

1450 Medical Center Dr
Rohnert Park, CA 94928
Phone (707) 546-3210

15031 Rinaldi St
San Fernando, CA 91345
Phone (818) 365-8051

26357 McBean Pkwy
Ste 155
Santa Clarita, CA 91355
Phone (661) 288-5940

925 Corporate Cntr Pkwy
Ste A
Santa Rosa, CA 95407
Phone (707) 543-2000

1165 Montgomery Dr
Santa Rosa, CA 95405
Phone (707) 525-5300

121 Sotoyome St
Santa Rosa, CA 95405
Phone (707) 546-3141

6580 Hembree Ln
Ste 270
Windsor, CA 95492
Phone (707) 838-2044

13020 Meridian Ave S
Everett, WA 98208
Phone (425) 357-3700

19020 33rd Ave W
Ste 210
Lynnwood, WA 98036
Phone 42556315001

18100 NE Union Hill Rd
Redmond, WA 98052
Phone (425) 498-2020

1221 Madison St
Ste 150
Seattle, WA 98104
Phone (206) 215-6433

Interoperability endpoints

  • Direct secure messaging: mpetrides571495@direct.peacehealth.org

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1461542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790208000000",
    "number": "1609221969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191044238",
            "telephone_number": "215-662-6918",
            "fax_number": "215-662-2664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 SPRUCE STREET",
            "address_2": "1 SILVERSTEIN, SUITE 130",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19104",
            "telephone_number": "215-662-6918",
            "fax_number": "215-662-2664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRIDES",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-04-25",
        "last_updated": "2026-09-24",
        "certification_date": "2026-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "PA",
            "license": "MD483462",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD483462",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.