Andrej Ljubisa Petronijevic, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

LL4279 Issued in NV

Practice address

2075 E Flamingo Rd
Las Vegas, NV 89119-5188

Phone

(702) 853-3576

NPI assigned

Jun 18, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NV

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

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

{
    "created_epoch": "1718668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1831932532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10503 CAMBRIDGE CT",
            "city": "GREAT FALLS",
            "state": "VA",
            "postal_code": "220664216",
            "telephone_number": "703-225-9682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2075 E FLAMINGO RD",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891195188",
            "telephone_number": "702-853-3576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRONIJEVIC",
        "first_name": "ANDREJ",
        "middle_name": "LJUBISA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-18",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NV",
            "license": "LL4279",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard Petrini
• Priscilla Strawberry Petro
• Lacey Petrocco
• Sarah Ilene Petrocelli, M.ED.
• Monica Petroff
• Gemechis N/a Petros, APRN
• Madison Petroski
• Hamlet Petrosyan
• Karine Petrosyan
• Narine Petrosyan

• Internal Medicine Physician in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Internal Medicine Physician in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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.