Douglas M Petroski, M.D.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

134641 Issued in NY

Practice address

68 Quaker Rd
Queensbury, NY 12804-1711

Phone

(518) 793-5601

Fax

(518) 793-5916

NPI assigned

Jul 12, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

Practice roles

Locations

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.

• Adirondack Orthopedic Physicians & Surgeons PC

  • Orthopaedic Surgery Physician
  • Glens Falls, NY
  • NPI 1942307020
  Medicare reassignment NPD

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395100800000",
    "number": "1851316905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 QUAKER RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128041711",
            "telephone_number": "518-793-5601",
            "fax_number": "518-793-5916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 QUAKER RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128041711",
            "telephone_number": "518-793-5601",
            "fax_number": "518-793-5916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROSKI",
        "first_name": "DOUGLAS",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2014-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NY",
            "license": "134641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00500243",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaret B Peca, MS, CCC/SLP
• Penley Chiropractic, P.C.
• Joel Penley, D.C.
• Patricia Pennington, RN
• Elizabeth Anne Petraccione, PT, DPT
• Anthony J. Pettinelli, CASAC-T
• Stacey Pfoh, LMSW
• Traci Lee Phillips-Perkins, LCSW-R
• Abigail Philpott, OTR/L
• Dennis J Picano, MD

• Orthopaedic Surgery Physician in Queensbury, NY
• Providers in Queensbury, NY by specialty
• Orthopaedic Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2014; 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.