Michael D Peterik, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

3397 Issued in AZ

Practice address

4550 E Bell Rd
Suite 170
Phoenix, AZ 85032-9306

Phone

(480) 443-8400

Fax

(480) 443-8697

NPI assigned

Jul 15, 2006

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366070400000",
    "number": "1720004245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 E BELL RD",
            "address_2": "SUITE 170",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850329306",
            "telephone_number": "480-443-8400",
            "fax_number": "480-443-8697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 E BELL RD",
            "address_2": "SUITE 170",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850329306",
            "telephone_number": "480-443-8400",
            "fax_number": "480-443-8697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERIK",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2013-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NJ",
            "license": "25MP00155600",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "3397",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "3397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Menghini MD PC
• Peter P. McKellar MD, PC
• Peter W. Mitchell, M.D.,P.C.
• Corey Peter, PHARM. D.
• Lisa Marie Peter
• Lynda A Peterman, M.D.
• Eric Petermann, DC
• Aaron Peters
• Allison Peters, RD
• Amy Meredith Peters, PT, DPT

• Physician Assistant in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.