Emanuel Petroulakis

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MA68837 Issued in NJ

Practice address

608 High St N
Montefiore G100
Millville, NJ 08332-3025

Phone

(856) 825-8080

NPI assigned

Jan 3, 2007

Last updated

May 24, 2021By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in PA, UT2 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

Hospitalist

Education

Rutgers New Jersey Medical School, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Intermountain Health Utah Valley Hospital Hospital, Provo, UT, CCN 460001

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: petroulakise@kch.securechart.com

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.

• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment Care Compare group NPD
• University of Pittsburgh Physicians

  • Gastroenterology Physician
  • Pittsburgh, PA
  • NPI 1619935004
  Medicare reassignment NPD
• Upmc Altoona

  dba Altoona Emergency Physicians

  • General Acute Care Hospital
  • Altoona, PA
  • NPI 1497831655
  Medicare reassignment NPD
• Ihc Health Services Inc

  dba Central Orem Pediatrics

  • Pediatrics Physician
  • Orem, UT
  • NPI 1992211445
  NPD
• Ihc Health Services, Inc.

  dba St George Adolescent Partial Hospitalization

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Intermountain Medical Group Grand Junction, LLC

  • Orthopaedic Surgery Physician
  • Grand Junction, CO
  • NPI 1356765556

  Internal Medicine

  NPD
• Intermountain Medical Group Grand Junction, LLC

  dba Grand Junction Palliative Care

  • Trauma Surgery Physician
  • Grand Junction, CO
  • NPI 1417562216
  NPD
• Intermountain Medical Group Grand Junction, LLC

  dba DME - Wellington Neurosurgery Clinic

  • Durable Medical Equipment & Medical Supplies
  • Grand Junction, CO
  • NPI 1609737618
  NPD
• University of Pittsburgh Physicians

  • Diagnostic Radiology Physician
  • Pittsburgh, PA
  • NPI 1285692699
  NPD
• University of Pittsburgh Physicians

  • Internal Medicine Physician
  • Pittsburgh, PA
  • NPI 1538127741
  NPD
• Upmc Altoona

  • Ambulatory Surgical Clinic/Center
  • Altoona, PA
  • NPI 1114926953
  NPD
• Millville Internal Medicine, LLC

  • Internal Medicine Physician
  • Millville, NJ
  • NPI 1992862429
  NPD (past)

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

• Ihc Health Services, Inc.

  dba Intermountain Health Utah Valley Hospital

  • General Acute Care Hospital
  • Provo, UT
  • NPI 1114025491
  Care Compare affiliation
• Ihc Health Services, Inc.

  dba Intermountain Health Infusion Center- Spanish Fork, A Service of Utah Valley Hospital

  • Infusion Therapy Clinic/Center
  • Spanish Fork, UT
  • NPI 1679426944

  Hospital

  Care Compare affiliation
• Ihc Health Services, Inc.

  dba Intermountain Health Infusion Center- American Fork, A Service of Utah Valley Hospital

  • Infusion Therapy Clinic/Center
  • American Fork, UT
  • NPI 1982557252

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621814400000",
    "number": "1801953310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 HIGH ST N",
            "address_2": "MONTEFIORE G100",
            "city": "MILLVILLE",
            "state": "NJ",
            "postal_code": "083323025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 HIGH ST N",
            "address_2": "MONTEFIORE G100",
            "city": "MILLVILLE",
            "state": "NJ",
            "postal_code": "083323025",
            "telephone_number": "856-825-8080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROULAKIS",
        "first_name": "EMANUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "MA68837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "emanuel.petroulakis@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Patricia L. Sparks, O.D., L.L.C.
• Shawonne Patterson, LSW
• Kathy A Pearson, LSW
• Bria Pernell
• Lauren L Peterson, PHARMD
• Sheila Sharmaine Pierce-Williams, MSW, LCSW,CAMS II
• Lisa Pisano, MS
• Malgorzata Piszcz-Connelly, M.D.
• Randall Eugene Pitone, MD
• Lynne M Porreca, OD

• Internal Medicine Physician in Millville, NJ
• Providers in Millville, NJ by specialty
• Internal Medicine Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.
• 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.