Christopher Conrad Petruccelli

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

D93898 Issued in MD

Practice address

22 S Greene St RM N3E09
Baltimore, MD 21201-1544

Phone

(410) 328-6110

NPI assigned

Mar 26, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

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

HospitalistAlso: Internal Medicine

Education

University of Maryland School of Medicine, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mdics at BWMC LLCGroup PAC ID 7315106184, 77 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of MD Baltimore Washington Medical Center Hospital, Glen Burnie, MD, CCN 210043
• Umd Rehabilitation & Orthopaedic Institute Hospital, Baltimore, MD, CCN 210058

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Mdics at BWMC LLC

  • Hospitalist Physician
  • Glen Burnie, MD
  • NPI 1306131578
  Medicare reassignment Care Compare group NPD
• Baltimore Washington Medical Center Inc.

  • General Acute Care Hospital
  • Glen Burnie, MD
  • NPI 1124016696

  Hospitalist

  NPD (past)

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

• Baltimore Washington Medical Center Inc.

  • General Acute Care Hospital
  • Glen Burnie, MD
  • NPI 1124016696
  Care Compare affiliation
• James Lawrence Kernan Hospital, Inc.

  • General Acute Care Hospital
  • Baltimore, MD
  • NPI 1841337805
  Care Compare affiliation

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1629539457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST RM N3E09",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST RM N3E09",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRUCCELLI",
        "first_name": "CHRISTOPHER",
        "middle_name": "CONRAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-26",
        "last_updated": "2022-11-04",
        "certification_date": "2022-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D93989",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "MD",
            "license": "D93898",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Petro
• John Petrone, D.D.S
• John D Petronis, M.D.
• Salina Petros
• Michelle Petrovic, M.D.
• Lauren Petrun, OTR/L
• Thomas William Petry, P.A.
• Briana Pettaway
• Brittany N Petteway, MS, OTR/L
• Latashia N Pettiford, CAC-AD

• Hospitalist Physician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Hospitalist Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2022; 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.