Michael D. Pettibon, M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

H0722 Issued in TX

Practice address

6606 LBJ Fwy
Ste 200
Dallas, TX 75240

Phone

(972) 715-5000

Fax

(972) 715-9976

NPI assigned

Dec 27, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

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

Anesthesiology

Education

University of Texas Medical School at San Antonio, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

U S Anesthesia Partners of Texas, PAGroup PAC ID 7315850351, 2,750 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Texas Health Harris Methodist Hurst-Euless-Bedford Hospital, Bedford, TX, CCN 450639

Merit-based Incentive Payment System (MIPS)

Final score

88.94 of 100Reported as group

Quality

91.31

Improvement activities

40

Cost

79.05

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mpettibon@direct.uspi.com

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.

• U. S. Anesthesia Partners of Texas, P.a.,

  • Anesthesiology Physician
  • Houston, TX
  • NPI 1548208564
  Medicare reassignment Care Compare group NPD
• U S Anesthesia Partners of Texas, PA

  • Interventional Pain Medicine Physician
  • Addison, TX
  • NPI 1053800391

  Anesthesiology

  NPD

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

• Texas Health Harris Methodist Hospital Hurst-Euless-Bedford

  • General Acute Care Hospital
  • Bedford, TX
  • NPI 1104845015
  Care Compare affiliation

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593561600000",
    "number": "1699752097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840853",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840853",
            "telephone_number": "972-715-5000",
            "fax_number": "972-233-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6606 LBJ FWY",
            "address_2": "STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75240",
            "telephone_number": "972-715-5000",
            "fax_number": "972-715-9976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIBON",
        "first_name": "MICHAEL",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-27",
        "last_updated": "2020-07-01",
        "certification_date": "2020-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "TX",
            "license": "H0722",
            "primary": false
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "TX",
            "license": "H0722",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "H0722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "132632410",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8EL144",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P01446653",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elen Petrosyan, R.D., L.D.
• Zachary James Petrowski
• Mariagrazia Petrozzi, MD
• Lyle Petrutsas, DDS
• Rosalynn Hernandez Petrutsas, LPC
• Jennifer L Pettibone, D.C.
• Wayne Earl Petties, LMSW
• Sylvia Dolores Pettigrew, B.S. SOCIOLOGY
• Kelli Pettinelli
• Janice M Pettis-Ingram, ED.D, LLC

• Anesthesiology Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Anesthesiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2020; 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.