Individual provider Active NPI

Nancy Berkas Petro, MD

  • Occupational Medicine Physician
  • Milwaukee, WI
National Provider Identifier
1881701282
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine PhysicianTaxonomy code 2083X0100X
License
22492-20 Issued in WI
Practice address
4111 W Mitchell St Ste 300
Milwaukee, WI 53215-1748
Phone
(414) 385-8800
Fax
(414) 671-8860
NPI assigned
Aug 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 22492 WI
Occupational Medicine Physician 2083X0100X 22492-20 WI Primary

Addresses

Primary practice location

4111 W Mitchell St Ste 300
Milwaukee, WI 53215-1748

Mailing address

4111 W Mitchell St Ste 300
Milwaukee, WI 53215-1748
Phone (414) 385-8800

Other practice location 1

9200 W Loomis Rd
#116
Franklin, WI 53132-9665
Phone (414) 529-9232

Other identifiers 1

IdentifierTypeStateIssuer
30511300MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
22492-20WIMDOccupational Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aurora Medical Group, Inc. PastSince Jul 24, 2022 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: npetro39435@direct.myadvocateaurora.org

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1881701282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4111 W MITCHELL ST STE 300",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532151748",
            "telephone_number": "414-385-8800",
            "fax_number": "414-671-8860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4111 W MITCHELL ST STE 300",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532151748",
            "telephone_number": "414-385-8800",
            "fax_number": "414-671-8860"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9200 W Loomis Rd",
            "address_2": "#116",
            "address_purpose": "LOCATION",
            "city": "Franklin",
            "state": "WI",
            "postal_code": "531329665",
            "country_code": "US",
            "telephone_number": "414-529-9232",
            "fax_number": "414-529-9292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETRO",
        "first_name": "NANCY",
        "middle_name": "BERKAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-23",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WI",
            "license": "22492",
            "primary": false
        },
        {
            "code": "2083X0100X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Occupational Medicine",
            "state": "WI",
            "license": "22492-20",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30511300",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.