Individual provider Active NPI

Robert Allan Petrarca, D.O.

  • Family Medicine Physician
  • Lewisburg, WV
National Provider Identifier
1851572580
Registry record updated Aug 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2268 Issued in WV
Practice address
400 N Jefferson St
Robert C. Byrd Clinic
Lewisburg, WV 24901-1177
Phone
(304) 645-3220
NPI assigned
Nov 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2268 WV Primary
Emergency Medicine Physician 207P00000X 2268 WV

Addresses

Primary practice location

400 N Jefferson St
Robert C. Byrd Clinic
Lewisburg, WV 24901-1177

Mailing address

400 N Jefferson St
Robert C. Byrd Clinic
Lewisburg, WV 24901-1177
Phone (304) 645-3220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
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

Enrollment IDStateProvider typePAC IDDetails
I20090219000023 WV Practitioner - Family PracticePractitioner - Emergency Medicine 4981769379 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
West Virginia School of Osteopathic Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

122 12TH St
Princeton, WV 24740-2312
Phone (304) 487-7936

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.34 of 100Reported as apm
Quality
79.86
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2268WVMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Princeton Community Hospital Assn., Inc. CurrentSince Jun 1, 2021 Accepting new patients
Princeton Community Hospital Assn., Inc CurrentSince Jun 1, 2021 Accepting new patients
Greenbrier Emergency Services, Inc. Emergency Medicine CurrentSince Sep 1, 2016 Accepting new patients
Princeton Community Hospital Assn Inc. Current Accepting new patients
Oak Hill Emergency Physicians, LLC Emergency Medicine Past Accepting new patients

Locations

401 E Vermillion St
Athens, WV 24712
Phone (304) 384-7325

500 Cherry St
Bluefield, WV 24701
Phone (304) 324-2614

430 Main St W
Oak Hill, WV 25901
Phone (276) 325-0678

122 12th St
Princeton, WV 24740
Phone (304) 487-7061

601 Colliers Way
Weirton, WV 26062
Phone (304) 364-5156

Interoperability endpoints

  • Direct secure messaging: rpetrarc@yourcarecommunity.org

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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": "1195689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470700800000",
    "number": "1851572580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N JEFFERSON ST",
            "address_2": "ROBERT C. BYRD CLINIC",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249011177",
            "telephone_number": "304-645-3220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N JEFFERSON ST",
            "address_2": "ROBERT C. BYRD CLINIC",
            "city": "LEWISBURG",
            "state": "WV",
            "postal_code": "249011177",
            "telephone_number": "304-645-3220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRARCA",
        "first_name": "ROBERT",
        "middle_name": "ALLAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-11-22",
        "last_updated": "2016-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "2268",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WV",
            "license": "2268",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisburg, WV

Sources for this page

Verify at the official NPI Registry.