Alexandre A Petrakian, MD

Primary specialty

Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X

License

K6234 Issued in TX

Practice address

1783 Troup Hwy
Tyler, TX 75701

Phone

(903) 595-2283

Fax

(903) 595-1063

NPI assigned

Oct 24, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 5

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

Specialty

Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christus Mother Frances Hospital Hospital, Tyler, TX, CCN 450102
• Christus Mother Frances Hospital Sulphur Springs Hospital, Sulphur Springs, TX, CCN 450236
• Christus Mother Frances Hospital- Jacksonville Hospital, Jacksonville, TX, CCN 451319
• Christus Good Shepherd Medical Center Hospital, Longview, TX, CCN 450032
• Ut Health East Texas Athens Hospital Hospital, Athens, TX, CCN 450389

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: apetrakian355187@ahs.direct-ci.com
• Direct secure messaging: apetrakian25631@christushealth.direct-ci.net

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.

• Christus Trinity Clinic Texas

  dba Christus Trinity Clinic

  • Family Medicine Physician
  • Tyler, TX
  • NPI 1285684225

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Mother Frances Hospital Jacksonville

  dba CHRISTUS Mother Frances Hospital - Jacksonville

  • Critical Access Hospital
  • Jacksonville, TX
  • NPI 1952306672
  Medicare reassignment
• Christus Trinity Clinic Texas

  dba Christus Trinity Clinic

  • Rural Health Clinic/Center
  • Winnsboro, TX
  • NPI 1801673165
  NPD
• Youngs Professional Services LLC

  dba YPS Anesthesia Services

  • Certified Registered Nurse Anesthetist
  • New Iberia, LA
  • NPI 1922178599
  NPD (past)

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

• Athens Hospital, LLC

  • General Acute Care Hospital
  • Athens, TX
  • NPI 1417465824
  Care Compare affiliation
• Christus Good Shepherd Medical Center

  • General Acute Care Hospital
  • Longview, TX
  • NPI 1124092036
  Care Compare affiliation
• Christus Hopkins Health Alliance

  dba Christus Mother Frances - Sulphur Springs

  • General Acute Care Hospital
  • Sulphur Springs, TX
  • NPI 1033568621
  Care Compare affiliation
• Mother Frances Hospital Jacksonville

  dba CHRISTUS Mother Frances Hospital - Jacksonville

  • Critical Access Hospital
  • Jacksonville, TX
  • NPI 1952306672
  Care Compare affiliation
• Mother Frances Hospital Regional Health Care Center

  dba Christus Mother Frances Hospital Tyler

  • General Acute Care Hospital
  • Tyler, TX
  • NPI 1679578439
  Care Compare affiliation

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675987200000",
    "number": "1811987654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1783 TROUP HWY",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757015869",
            "telephone_number": "903-595-2283",
            "fax_number": "903-595-1063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1783 TROUP HWY",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "75701",
            "telephone_number": "903-595-2283",
            "fax_number": "903-595-1063"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "126 W Main St Ste C",
            "address_purpose": "LOCATION",
            "city": "Gun Barrel City",
            "state": "TX",
            "postal_code": "751565404",
            "country_code": "US",
            "telephone_number": "903-595-2283",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1505 State Highway 19 S",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "TX",
            "postal_code": "757518950",
            "country_code": "US",
            "telephone_number": "903-675-6800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1108 S Buffalo St",
            "address_purpose": "LOCATION",
            "city": "Canton",
            "state": "TX",
            "postal_code": "751032304",
            "country_code": "US",
            "telephone_number": "903-595-2283",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETRAKIAN",
        "first_name": "ALEXANDRE",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2023-02-10",
        "certification_date": "2023-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K6234",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "TX",
            "license": "K6234",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "TX",
            "license": "K6234",
            "primary": false
        },
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "TX",
            "license": "K6234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "045057901",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "060060260",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TEXAS",
            "identifier": "87792Y",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SMITH COUNTY INDIGENT",
            "identifier": "045057901",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1776521",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sara H Perry
• Forrest Rice Persing, PA
• Peter H Langsjoen MD PA
• Brenda Peters
• Anne B Petitto
• Britknea Pettigrew
• Melinda Kay Pettit
• Robert Ryan Pettit, CRNA
• Joseph Lee Petty, M.D.
• Shaunda Rena Petty

• Clinical Cardiac Electrophysiology Physician in Tyler, TX
• Providers in Tyler, TX by specialty
• Clinical Cardiac Electrophysiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2023; 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.