Active NPI
Helen Petros, NP, PA-C
- Nurse Practitioner
- Springfield, MA
National Provider Identifier
1689671505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- RN146587
- Practice address
- 3455 Main St Ste 5
Springfield, MA 01107-1147 - Phone
- (413) 733-9600
- Fax
- (413) 732-6534
- NPI assigned
- Jul 7, 2005
- Last updated
- Feb 4, 2019
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | RN146587 | MA | Primary |
Addresses
Primary practice location
3455 Main St Ste 5
Springfield, MA 01107-1147
Mailing address
4366 Kukui Grove St
Ste 201
Lihue, HI 96766-2006
Phone (808) 263-3233
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 970026776 | Other | RAILROAD MEDICARE | |
| 146587 | Other | CONNECTICARE |
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)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6956 | CA | MD | Pediatric Occupational Therapist |
| RN146587 | MA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kailua Dermatology Centers of Hawaii, LLC | Past | Accepting new patients | |
| Cornelia M Pessoa, MD | Past | Accepting new patients | |
| Hawaiian Islands Dermatology, LLC | Past | Accepting new patients |
Organizations & group practices 3
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.
-
- Dermatology Physician
- Kailua, HI
- NPI 1891310355
-
- Medical Physician Assistant
- Kailua, HI
- NPI 1588843502
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1549238400000",
"number": "1689671505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4366 KUKUI GROVE ST",
"address_2": "STE 201",
"city": "LIHUE",
"state": "HI",
"postal_code": "967662006",
"telephone_number": "808-263-3233",
"fax_number": "808-263-3220"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3455 MAIN ST STE 5",
"city": "SPRINGFIELD",
"state": "MA",
"postal_code": "011071147",
"telephone_number": "413-733-9600",
"fax_number": "413-732-6534"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETROS",
"first_name": "HELEN",
"credential": "NP, PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-07",
"last_updated": "2019-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "MA",
"license": "RN146587",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "970026776",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONNECTICARE",
"identifier": "146587",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Springfield, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.