Active NPI
Andrew Petras, OD
- Optometrist
- Palm Springs, CA
National Provider Identifier
1629114269
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OE004705P
- Practice address
- 148 Eastlake Dr
Palm Springs, CA 92264 - Phone
- (760) 702-0775
- Fax
- (760) 837-3894
- NPI assigned
- Jan 30, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | OE004705P | PA | Primary |
Addresses
Primary practice location
148 Eastlake Dr
Palm Springs, CA 92264
Mailing address
148 Eastlake Dr
7 Lakes CC
Palm Springs, CA 92264
Phone (760) 702-0775
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OE004705P | PA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1629114269",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "148 EASTLAKE DR",
"address_2": "7 LAKES CC",
"city": "PALM SPRINGS",
"state": "CA",
"postal_code": "92264",
"telephone_number": "760-702-0775",
"fax_number": "760-837-3894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "148 EASTLAKE DR",
"city": "PALM SPRINGS",
"state": "CA",
"postal_code": "92264",
"telephone_number": "760-702-0775",
"fax_number": "760-837-3894"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETRAS",
"first_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PA",
"license": "OE004705P",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Palm Springs, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.