Jason Petrasic, M.D.

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

Q9878 Issued in TX

Practice address

5700 Dallas Pkwy
Frisco, TX 75034-9580

Phone

(469) 515-7100

Fax

(469) 515-7101

NPI assigned

Apr 13, 2013

Last updated

Aug 23, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Star Orthopedics and Sports Medicine PLLC

  • Orthopaedic Surgery Physician
  • Frisco, TX
  • NPI 1891200168
  Medicare reassignment NPD
• Texas Scottish Rite Hospital for Crippled Children

  • Pediatric Orthopaedic Surgery Physician
  • Dallas, TX
  • NPI 1598188948
  Medicare reassignment NPD
• University of Texas Southwestern Medical Center at Dallas

  • Anesthesiology Physician
  • Dallas, TX
  • NPI 1942270566
  Medicare reassignment NPD
• Star Orthopedics and Sports Medicine PLLC

  • Orthopaedic Surgery Physician
  • Coppell, TX
  • NPI 1033939863
  NPD
• The University of Texas Southwestern Medical Center at Dallas

  • Clinical Medical Laboratory
  • Dallas, TX
  • NPI 1396832713
  NPD
• University of Texas Southwestern Medical Center at Dallas

  dba Multi Specialty Clinic in Tarrant County

  • Pediatrics Physician
  • Southlake, TX
  • NPI 1275838732

  Physical Medicine & Rehabilitation

  NPD
• Texas Scottish Rite Hospital for Crippled Children

  • Special Hospital
  • Dallas, TX
  • NPI 1760628184
  NPD (past)

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

{
    "created_epoch": "1365811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629676800000",
    "number": "1740623388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 DALLAS PKWY",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750349580",
            "telephone_number": "469-515-7100",
            "fax_number": "469-515-7101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 DALLAS PKWY",
            "city": "FRISCO",
            "state": "TX",
            "postal_code": "750349580",
            "telephone_number": "469-515-7100",
            "fax_number": "469-515-7101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2222 Welborn St",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752193924",
            "country_code": "US",
            "telephone_number": "214-559-5000",
            "fax_number": "214-443-7309",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5550 Warren Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Frisco",
            "state": "TX",
            "postal_code": "750347399",
            "country_code": "US",
            "telephone_number": "469-850-0680",
            "fax_number": "469-850-0681",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3800 Gaylord Pkwy Ste 850",
            "address_purpose": "LOCATION",
            "city": "Frisco",
            "state": "TX",
            "postal_code": "750340248",
            "country_code": "US",
            "telephone_number": "469-857-2222",
            "fax_number": "469-857-2223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETRASIC",
        "first_name": "JASON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-04-13",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "FL",
            "license": "17539",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "TX",
            "license": "BP10047555",
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "Q9878",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "TX",
            "license": "Q9878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Elizabeth Peters, M.S., CCC-SLP
• Dillon Peterson
• Lindsey Peterson, RN, IBCLC
• Stephanie Kay Peterson, APRN, MSN, FNP-BC
• Thomas Peterson, DC
• Pauline Petrovski, MD
• Diana Pham, DPT
• Jennifer Pham
• Kevin Pham
• Khoi Pham, D.O.

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Frisco, TX
• Providers in Frisco, TX by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.