NPIMap

Individual provider Active NPI

Anthony T. Petrick, M.D.

  • Surgery Physician
  • Danville, PA
National Provider Identifier
1609831965
Registry record updated Aug 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
MD059063L Issued in PA
Practice address
100 N Academy Ave
Danville, PA 17822-2170
Phone
(570) 271-6361
NPI assigned
Apr 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X MD059063L PA Primary

Addresses

Primary practice location

100 N Academy Ave
Danville, PA 17822-2170

Mailing address

100 N Academy Ave
Danville, PA 17822-3034
Phone (570) 271-6144

Other identifiers 1

IdentifierTypeStateIssuer
001583257MedicaidPA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address apetrick76732@direct.geisinger.edu Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080326000249 PA Practitioner - General Surgery 8022194422 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Georgetown University School of Medicine, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Geisinger ClinicGroup PAC ID 5395657001, 3,432 clinicians

Practice addresses (Care Compare)

100 N Academy Ave
Danville, PA 17822-9800
Phone (570) 271-6541

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Upper gastrointestinal (GI) endoscopy for acid reflux36

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD059063LPAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Geisinger Clinic Current Accepting new patients
Geisinger Clinic CurrentSince Jan 1, 2008 Accepting new patients
Geisinger Clinic CurrentSince Jan 1, 2008 Accepting new patients
Geisinger-HM Joint Venture, LLC Past Accepting new patients
Geisinger Medical Center Past Accepting new patients
Latrobe Surgical Group LLC Surgery Past Accepting new patients
Geisinger Clinic Past Accepting new patients

Locations

503 N 21st St
Camp Hill, PA 17011
Phone (717) 763-2100

42 N Scott St
Carbondale, PA 18407
Phone (570) 282-6660

4203 Hospital Rd
Coal Township, PA 17866
Phone (570) 486-4588

100 N Academy Ave
Danville, PA 17822

1020 Thompson St
Jersey Shore, PA 17740
Phone (570) 398-0100

400 Highland Ave
Lewistown, PA 17044
Phone (717) 242-7473

10 Choate Cir
Montoursville, PA 17754
Phone (570) 368-5566

255 Route 220 Hwy
Ste 205
Muncy, PA 17756
Phone (570) 308-2445

132 Abigail Ln
Port Matilda, PA 16870
Phone (814) 272-5011

1800 Mulberry St
Scranton, PA 18510
Phone (570) 703-7351

950 E Mountain Dr
Wilkes Barre, PA 18711
Phone (570) 808-3290

1000 E Mountain Blvd
Wilkes Barre, PA 18711
Phone (570) 808-7399

Interoperability endpoints

  • Direct secure messaging: apetrick76732@direct.geisinger.edu

Organizations & group practices 7

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.

Hospital & facility affiliations 56

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

View all 56

NPI Registry JSON

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1609831965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178223034",
            "telephone_number": "570-271-6144",
            "fax_number": "570-271-6578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N ACADEMY AVE",
            "city": "DANVILLE",
            "state": "PA",
            "postal_code": "178222170",
            "telephone_number": "570-271-6361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRICK",
        "first_name": "ANTHONY",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-19",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD059063L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001583257",
            "state": "PA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "apetrick76732@direct.geisinger.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "100 N Academy Ave",
            "city": "Danville",
            "state": "PA",
            "country_code": "US",
            "postal_code": "178222170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Danville, PA

Sources for this page

Verify at the official NPI Registry.