Individual provider Active NPI

Gary Petner, PA-C

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1679545750
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA051206 Issued in PA
Practice address
2757 N 5TH St
Philadelphia, PA 19133-2700
Phone
(215) 839-9661
Fax
(215) 309-3533
NPI assigned
Feb 3, 2006
Last updated
Apr 10, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 25MP00106100 NJ
Physician Assistant 363A00000X MA051206 PA Primary

Addresses

Primary practice location

2757 N 5TH St
Philadelphia, PA 19133-2700

Mailing address

7040 Torresdale Ave
Philadelphia, PA 19135-1915
Phone (215) 605-5465

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20150316002211 PA Practitioner - Physician Assistant 7416274253 Reassigns benefits to 2 organizations
I20181005000077 NJ Practitioner - Physician Assistant 7416274253 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
American Current Care of New Jersey PA CurrentSince Apr 11, 2025 Accepting new patients
First Brick Clinic CurrentSince Jan 12, 2025 Accepting new patients
Ars Treatment Centers, P.C. CurrentSince Jul 22, 2021 Accepting new patients
American Current Care P.a. CurrentSince Apr 11, 2025 Accepting new patients
Orthonj LLC CurrentSince Sep 1, 2020 Accepting new patients
American Current Care of New Jersey PA CurrentSince Apr 11, 2025 Accepting new patients
American Current Care P.a. CurrentSince Apr 11, 2025 Accepting new patients
Orthonj LLC CurrentSince Sep 1, 2020 Accepting new patients
American Current Care of New Jersey PA Current Accepting new patients
Fracture Bracing Past Accepting new patients
Delaware Valley Orthopaedic Assoc LTD. Past Accepting new patients

Locations

595 Division St
Elizabeth, NJ 07201
Phone (908) 289-5646

2315 Route 34
Manasquan, NJ 08736
Phone (732) 974-0404

817 E Gate Dr
#102
Mount Laurel, NJ 08054
Phone (856) 778-1090

5 Plainsboro Rd
Ste 100
Plainsboro, NJ 08536
Phone (609) 750-1600

325 Princeton Ave
Princeton, NJ 08540
Phone (609) 924-5044

220 S Main St
Ste A
Butler, PA 16001

2010 Levick St
Philadelphia, PA 19149
Phone (215) 537-4755

2317 E Westmoreland St
Philadelphia, PA 19134
Phone (215) 291-3115

15 Freeport Rd
Ste 100
Pittsburgh, PA 15215
Phone (412) 784-1551

5080 Spectrum Dr
Ste 1200W
Addison, TX 75001

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1138924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1679545750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7040 TORRESDALE AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191351915",
            "telephone_number": "215-605-5465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2757 N 5TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191332700",
            "telephone_number": "215-839-9661",
            "fax_number": "215-309-3533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETNER",
        "first_name": "GARY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-03",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00106100",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA051206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.