Christine A Petruzzo, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

211695 Issued in MA

Practice address

110 Liberty Street
Brockton, MA 02301-5521

Phone

(508) 894-0400

Fax

(508) 894-0523

NPI assigned

Dec 7, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

University of Massachusetts Medical School, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Signature Healthcare Medical Group IncGroup PAC ID 7719876267, 250 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

88.83 of 100Reported as group

Quality

70.13

Promoting interoperability

100

Improvement activities

40

Cost

75.97

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: christine.petruzzo@direct.signature.masshiway.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.

• Signature Healthcare Medical Group Inc

  • Internal Medicine Physician
  • Brockton, MA
  • NPI 1508804949
  Medicare reassignment Care Compare group NPD
• Bridgewater Goddard Park Medical Associates, Inc.

  • Multi-Specialty Clinic/Center
  • Brockton, MA
  • NPI 1417932591
  NPD (past)
• Michael C. Randon, MD

  • Family Medicine Physician
  • Middleboro, MA
  • NPI 1194916627
  NPD (past)

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

{
    "created_epoch": "1133913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1450137600000",
    "number": "1831174440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 LIBERTY STREET",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015521",
            "telephone_number": "508-894-0400",
            "fax_number": "508-894-0523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 LIBERTY STREET",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015521",
            "telephone_number": "508-894-0400",
            "fax_number": "508-894-0523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRUZZO",
        "first_name": "CHRISTINE",
        "middle_name": "A",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-07",
        "last_updated": "2015-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "211695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0324451",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William Perry Petitpas
• Joan Petros, DMD
• Dana Petrosevich
• Ashley Mary Petrou, PA-C
• Gabriella Petruzziello
• Nina Petruzzo, OT
• Kathleene Pfeffenberger
• Megan Pflanz
• Brendan Phan
• Gayle Elaine Phaneuf, RD

• Nurse Practitioner in Brockton, MA
• Providers in Brockton, MA by specialty
• Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2015; 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.