Individual provider Active NPI

Karolina Petro, M.D.

  • Pediatrics Physician
  • Binghamton, NY
National Provider Identifier
1730611484
Registry record updated Jul 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
316746 Issued in NY
Practice address
10-42 Mitchell Ave
Binghamton, NY 13903-1617
Phone
(607) 762-2468
NPI assigned
Mar 31, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 25MA10796200 NJ
Pediatrics Physician 208000000X 316746 NY Primary

Addresses

Primary practice location

10-42 Mitchell Ave
Binghamton, NY 13903-1617

Mailing address

33 Lewis Rd FL 2
Binghamton, NY 13905-1055
Phone (607) 770-0025

Other names 1

  • Karolina Bukala Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20220808001845 NY Practitioner - Pediatric Medicine 3072918333 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
316746NYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
United Medical Associates, P.C. CurrentSince Jul 18, 2022 Accepting new patients
United Health Services Hospitals, Inc. CurrentSince Jul 18, 2022 Accepting new patients
United Medical Associates PC CurrentSince Jul 18, 2022 Accepting new patients
United Health Services Hospitals, Inc. Past Accepting new patients

Locations

10-42 Mitchell Ave
Binghamton, NY 13903
Phone (607) 762-2468

33 Lewis Rd
Fl 2
Binghamton, NY 13905
Phone (607) 729-8156

91 Chenango Bridge Rd
Binghamton, NY 13901
Phone (607) 648-4151

33-57 Harrison St
Johnson City, NY 13790
Phone (607) 763-6412

Interoperability endpoints

  • FHIR API: https://epicproxy.et1127.epichosted.com/FHIRproxy/api/FHIR/R4/

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1490918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656633600000",
    "number": "1730611484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 LEWIS RD FL 2",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139051055",
            "telephone_number": "607-770-0025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10-42 MITCHELL AVE",
            "city": "BINGHAMTON",
            "state": "NY",
            "postal_code": "139031617",
            "telephone_number": "607-762-2468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRO",
        "first_name": "KAROLINA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-31",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NJ",
            "license": "25MA10796200",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NY",
            "license": "316746",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KAROLINA",
            "last_name": "BUKALA",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Binghamton, NY

Sources for this page

Verify at the official NPI Registry.