Active NPI
Robert Jerry Petrillo, DO
- Anesthesiology Physician
- Hartford, CT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 76176
- Practice address
- 80 Seymour St
Hartford, CT 06106-3300 - Phone
- (860) 545-5000
- NPI assigned
- Mar 29, 2019
- Last updated
- Sep 15, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 76176 | CT | Primary |
| Anesthesiology Physician | 207L00000X | 1013106 | MA |
Addresses
Primary practice location
80 Seymour St
Hartford, CT 06106-3300
Mailing address
100 Retreat Ave Ste 900
Hartford, CT 06106-2553
Phone (860) 218-2204
Other practice location 1
41 Mall Rd
Burlington, MA 01805-0001
Phone (781) 744-8000
Other practice location 2
263 Farmington Ave
Farmington, CT 06030-0001
Phone (860) 679-3600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA, CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
326 Washington St
Norwich, CT 06360-2740
Phone (860) 282-0833
65 Memorial Rd
Suite 500
West Hartford, CT 06107-4233
Phone (860) 586-8655
80 Semour St
Hartford, CT 06106-3315
Phone (860) 972-2117
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.98 of 100
- Quality
- 76.59
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 76176 | CT | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lahey Clinic, Inc | Current | Accepting new patients | |
| Integrated Anesthesia Associates LLC | Anesthesiology | Current | Accepting new patients |
Locations
100 Retreat Ave
Ste 900
Hartford, CT 06106
Phone (860) 218-2204
80 Seymour St
Hartford, CT 06106
Phone (860) 545-2249
99 E River Dr
Fl 5
Hartford, CT 06108
Phone (860) 282-4022
41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400
Interoperability endpoints
- robert.petrillo@xdr.hhchealthdirect.org
- rpetrillo199771@direct.bilh.masshiway.net
Organizations & group practices 2
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.
-
- Anesthesiology Physician
- Shelton, CT
- NPI 1881636397
-
- Internal Medicine Physician
- Peabody, MA
- NPI 1063447316
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Hartford, CT
- NPI 1770696643
-
- General Acute Care Hospital
- Hartford, CT
- NPI 1902834880
-
- Psychiatric Hospital Unit
- Middletown, CT
- NPI 1154263713
-
- General Acute Care Hospital
- Farmington, CT
- NPI 1669466561
-
- General Acute Care Hospital
- Norwich, CT
- NPI 1467517235
-
- General Acute Care Hospital
- Norwich, CT
- NPI 1639135718
-
- Psychiatric Hospital Unit
- Norwich, CT
- NPI 1730243536
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1553817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726358400000",
"number": "1861953002",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 RETREAT AVE STE 900",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061062553",
"telephone_number": "860-218-2204"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "80 SEYMOUR ST",
"city": "HARTFORD",
"state": "CT",
"postal_code": "061063300",
"telephone_number": "860-545-5000"
}
],
"practiceLocations": [
{
"address_1": "41 Mall Rd",
"address_purpose": "LOCATION",
"city": "Burlington",
"state": "MA",
"postal_code": "018050001",
"country_code": "US",
"telephone_number": "781-744-8000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "263 Farmington Ave",
"address_purpose": "LOCATION",
"city": "Farmington",
"state": "CT",
"postal_code": "060300001",
"country_code": "US",
"telephone_number": "860-679-3600",
"fax_number": "860-679-1275",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "PETRILLO",
"first_name": "ROBERT",
"middle_name": "JERRY",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-03-29",
"last_updated": "2024-09-15",
"certification_date": "2024-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "CT",
"license": "76176",
"primary": true
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "MA",
"license": "1013106",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.
- 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.