Joan Sybell Petalcorin, M.D.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

0101246323 Issued in VA

Practice address

5615 Deauville Ste 240
Midland, TX 79706-2709

Phone

(432) 221-5560

Fax

(757) 963-6375

NPI assigned

Mar 8, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Physical Medicine and RehabilitationAlso: Interventional Pain Management

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dora Roberts Rehabilitation CenterGroup PAC ID 0941285498, 114 clinicians

Premier Family Care I IncGroup PAC ID 2567351372, 71 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Midland Memorial Hospital Hospital, Midland, TX, CCN 450133

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: joan.petalcorin.1@3522.direct.athenahealth.com
• FHIR API: https://api.platform.athenahealth.com/18292/brand/1/csg/1/fhir/r4

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.

• Premier Family Care I, Inc

  • General Practice Physician
  • Midland, TX
  • NPI 1275522864
  Medicare reassignment Care Compare group NPD
• Dora Roberts Rehabilitation Center

  • Rehabilitation Clinic/Center
  • Big Spring, TX
  • NPI 1760486708
  Care Compare group
• Premier Physicians

  • Physician Assistant
  • Midland, TX
  • NPI 1316241995
  NPD (past)

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

• Midland County Hospital District

  • General Acute Care Hospital
  • Midland, TX
  • NPI 1255325817
  Care Compare affiliation

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1619008141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4214 ANDREWS HWY STE 240",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797034817",
            "telephone_number": "757-963-6507",
            "fax_number": "757-963-6375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5615 DEAUVILLE STE 240",
            "city": "MIDLAND",
            "state": "TX",
            "postal_code": "797062709",
            "telephone_number": "432-221-5560",
            "fax_number": "757-963-6375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETALCORIN",
        "first_name": "JOAN",
        "middle_name": "SYBELL",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2023-03-07",
        "certification_date": "2020-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "0101246323",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MISSOURI TEMP LICENSE",
            "identifier": "2005032249",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX MEDICARE-PREMIER",
            "identifier": "518857YPVD",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KANSAS TEMPORARY LICENSE",
            "identifier": "6310",
            "state": "KS"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "joan.petalcorin.1@3522.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "5615 Deauville Ste 240",
            "city": "Midland",
            "state": "TX",
            "country_code": "US",
            "postal_code": "797062709",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physical Medicine & Rehabilitation Physician in Midland, TX
• Providers in Midland, TX by specialty
• Physical Medicine & Rehabilitation Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.