Michael Darby Pettersen, MD

Primary specialty

Pediatric Cardiology PhysicianTaxonomy code 2080P0202X

License

CDRH.0050708 Issued in CO

Practice address

2055 N High St
Suite 255
Denver, CO 80205-5503

Phone

(303) 860-9933

Fax

(303) 839-5844

NPI assigned

Jun 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO, KS2 enrollments

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 2

Specialty

Cardiovascular Disease (Cardiology)Also: Pediatric Medicine

Education

Mayo Medical School, 1994

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations (25 of 27)

Interoperability endpoints

• Direct secure messaging: michael.pettersen@hca3.eclinicaldirectplus.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.

• Obstetrix Medical Group of Colorado P C

  • Pediatric Cardiology Physician
  • Denver, CO
  • NPI 1497779276

  KS

  Medicare reassignment
• Obstetrix Medical Group of Colorado P C

  • Neonatal-Perinatal Medicine Physician
  • Denver, CO
  • NPI 1700983103
  Medicare reassignment
• Healthone Clinic Services - Pediatric Specialties LLC

  • Pediatrics Physician
  • Denver, CO
  • NPI 1720293251

  Pediatric Cardiology

  NPD

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1700824430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2055 N HIGH ST STE 255",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802055663",
            "telephone_number": "303-860-9933",
            "fax_number": "303-839-5844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 N HIGH ST",
            "address_2": "SUITE 255",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802055503",
            "telephone_number": "303-860-9933",
            "fax_number": "303-839-5844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTERSEN",
        "first_name": "MICHAEL",
        "middle_name": "DARBY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "CO",
            "license": "CDRH.0050708",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristina Ann Petrosino, RDH
• Mary Elaine Petrucci
• Erin S Petrush, OTD, OTR/L
• Mandy Petry, PA-C
• Renate Petters
• Kelly Joy Pettijohn, M.D.
• Maxwell Ruskin Pettijohn, O.D.
• David Pettit, MD
• Kathi Pettit
• William Pettit, PTA

• Pediatric Cardiology Physician in Denver, CO
• Providers in Denver, CO by specialty
• Pediatric Cardiology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; 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.