John G Petty, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

35259 Issued in CO

Practice address

2423 E Main
Ste 4
Cortez, CO 81321

Phone

(970) 565-8809

Fax

(970) 565-8881

NPI assigned

Feb 1, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MT, HI2 enrollments

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 2

Specialty

Ophthalmology

Education

University of California, San Diego School of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eugene W M NG MD LLC 6 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

State licenses

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.

• Eugene W M NG MD LLC

  • Ophthalmology Physician
  • Honolulu, HI
  • NPI 1396014031

  HI, Ophthalmology

  Medicare reassignment Care Compare group NPD
• Billings Clinic

  • Emergency Care Clinic/Center
  • Billings, MT
  • NPI 1326104845

  MT

  Medicare reassignment NPD
• Hawaii Vision Institute LLC

  • Ophthalmology Physician
  • Hilo, HI
  • NPI 1720879752

  HI, Ophthalmology

  Medicare reassignment NPD
• Alpine Eye Clinic Optical, LLC

  • Optician
  • Cortez, CO
  • NPI 1518939834
  NPD Authorized official
• Billings Clinic

  • General Practice Physician
  • Billings, MT
  • NPI 1376598714
  NPD
• Billings Clinic

  • Physical Therapist
  • Billings, MT
  • NPI 1740630268
  NPD
• Pacific Eye Surgery Center, Inc.

  • Ophthalmologic Surgery Clinic/Center
  • Honolulu, HI
  • NPI 1134112840
  NPD

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192492800000",
    "number": "1881665263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2423 E MAIN",
            "address_2": "STE 4",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "81321",
            "telephone_number": "970-565-8809",
            "fax_number": "970-565-8881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2423 E MAIN",
            "address_2": "STE 4",
            "city": "CORTEZ",
            "state": "CO",
            "postal_code": "81321",
            "telephone_number": "970-565-8809",
            "fax_number": "970-565-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "JOHN",
        "middle_name": "G",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-01",
        "last_updated": "2007-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "CO",
            "license": "35259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01352590",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kerry Jo Paumen, CERTIFIED OPTICIAN
• Tiffanie Payne-Lake
• Jenna Pearce, RN
• John R. Pearsall, M.D.
• Monte Yukio Pescador, LPCC, ACMHC
• Kenneth Hurd Picillo, CRNA
• Herb B Pike, P.T.
• Kari Plante, RDH
• Renee Ann Podunovich, M.A., LPC
• Della Louise Pope

• All providers in Cortez, CO
• Ophthalmology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; 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.

Verify at the official NPI Registry.