NPIMap

Individual provider Active NPI

Jeffrey Robert Petrella, M.D.

  • Diagnostic Radiology Physician
  • Durham, NC
National Provider Identifier
1841386158
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
97-01542 Issued in NC
Practice address
4101 N Roxboro St
Durham, NC 27704-2121
Phone
(919) 684-8111
NPI assigned
Oct 5, 2006
Last updated
Nov 6, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 97-01542 NC Primary

Addresses

Primary practice location

4101 N Roxboro St
Durham, NC 27704-2121

Mailing address

4101 N Roxboro St
Durham, NC 27704-2121
Phone (919) 684-8111

Other identifiers 1

IdentifierTypeStateIssuer
891059FMedicaidNC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091217000584 NC Practitioner - Diagnostic Radiology 8527108844 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Rutgers New Jersey Medical School, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Duke Health Integrated Practice IncGroup PAC ID 8325412737, 3,140 clinicians

Practice addresses (Care Compare)

2301 Erwin Rd
Durham, NC 27705-4699
Phone (919) 684-8111

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
97-01542NCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Duke University Health System, Inc. Diagnostic Radiology CurrentSince Jul 9, 2024 Accepting new patients
Duke Health Integrated Practice, Inc. CurrentSince Jul 1, 2023 Accepting new patients
Duke University Health System Inc Diagnostic Radiology CurrentSince Jan 1, 2026 Accepting new patients
Duke University Health System, Inc. Diagnostic Radiology CurrentSince Jan 1, 2026 Accepting new patients
Duke University Health System Inc Diagnostic Radiology CurrentSince Jul 1, 2025 Accepting new patients
Duke University Health System, Inc. Diagnostic Radiology CurrentSince Jan 1, 2019 Accepting new patients
Duke University Health System Inc Diagnostic Radiology CurrentSince Jul 1, 2014 Accepting new patients
Duke Health Integrated Practice, Inc CurrentSince Jul 1, 2023 Accepting new patients
Duke University Health System, Inc. Diagnostic Radiology CurrentSince Jul 1, 2025 Accepting new patients

Locations

2301 Erwin Rd
Durham, NC 27705
Phone (919) 668-0289

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588

5213 S Alston Ave
Durham, NC 27713
Phone (919) 620-4700

Interoperability endpoints

  • Direct secure messaging: jpetrella60215@direct.medicine.duke.edu

Organizations & group practices 9

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699228800000",
    "number": "1841386158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 N ROXBORO ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042121",
            "telephone_number": "919-684-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 N ROXBORO ST",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277042121",
            "telephone_number": "919-684-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRELLA",
        "first_name": "JEFFREY",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "97-01542",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891059F",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.