Richard Petrella Sr., MD

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

94630 Issued in GA

Practice address

1497 Fair Rd Ste 205
Statesboro, GA 30458-0824

Phone

(912) 259-9881

Fax

(912) 259-9883

NPI assigned

Jun 8, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in PA, GA2 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

Interventional CardiologyAlso: Cardiovascular Disease (Cardiology)

Education

Hahnemann University College of Medicine, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

East Georgia Hma Physician Management LLCGroup PAC ID 7214068592, 42 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• East Georgia Regional Medical Center Hospital, Statesboro, GA, CCN 110075
• Wellstar MCG Health, Affiliated With Med Col Hospital, Augusta, GA, CCN 110034
• St Joseph'S Hospital - Savannah Hospital, Savannah, GA, CCN 110043
• Optim Medical Center - Screven Hospital, Sylvania, GA, CCN 111312

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: richard.petrella.1@8824.direct.athenahealth.com

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.

• East Georgia Hma Physician Management, LLC

  • Internal Medicine Physician
  • Statesboro, GA
  • NPI 1487983151

  Interventional Cardiology

  Medicare reassignment Care Compare group NPD
• Regional Health Services Inc

  • Family Medicine Physician
  • Erie, PA
  • NPI 1174520654
  Medicare reassignment NPD
• Jamestown Area Medical Associates, L.L.P.

  • Internal Medicine Physician
  • Jamestown, NY
  • NPI 1528010766
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Au Medical Center, Inc

  • General Acute Care Hospital
  • Augusta, GA
  • NPI 1437135902
  Care Compare affiliation
• East Georgia Regional Medical Center, LLC

  • General Acute Care Hospital
  • Statesboro, GA
  • NPI 1265486278
  Care Compare affiliation
• Saint Joseph'S Hospital, Inc.

  • General Acute Care Hospital
  • Savannah, GA
  • NPI 1063406684
  Care Compare affiliation
• Screven County Hospital, LLC

  • Critical Access Hospital
  • Sylvania, GA
  • NPI 1225339898
  Care Compare affiliation

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1902800972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1497 FAIR RD STE 205",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304580824",
            "telephone_number": "912-259-9881",
            "fax_number": "912-259-9883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1497 FAIR RD STE 205",
            "city": "STATESBORO",
            "state": "GA",
            "postal_code": "304580824",
            "telephone_number": "912-259-9881",
            "fax_number": "912-259-9883"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 E 2nd St Fl 2",
            "address_2": "2nd Floor",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165071579",
            "country_code": "US",
            "telephone_number": "814-456-8980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETRELLA",
        "first_name": "RICHARD",
        "name_suffix": "Sr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-08",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "PA",
            "license": "MD031766-E",
            "primary": false
        },
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "GA",
            "license": "94630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "richard.w.petrella@upmcdirect.com",
            "affiliation": "Y",
            "affiliationName": "UPMC",
            "address_1": "600 Grant St",
            "address_2": "Floor 58",
            "city": "Pittsburgh",
            "state": "PA",
            "country_code": "US",
            "postal_code": "152192702",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "richard.petrella.1@8824.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "1497 Fair Rd Ste 205",
            "city": "Statesboro",
            "state": "GA",
            "country_code": "US",
            "postal_code": "304580824",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Nekey Chiffon Perkins, FNP-C
• William Warren Perrine, M.S., CCC-A
• Paige Jontee Perry
• Victoria Perry
• Caroline Eliabeth Peterson
• Victoria Pettofrezzo, PT, DPT
• Brandy Anne Petty, M.S., ATC, LAT
• Heather Petty
• Philip L Bertucci,MD,LLC
• Allison Paige Phillips

• Interventional Cardiology Physician in Statesboro, GA
• Providers in Statesboro, GA by specialty
• Interventional Cardiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.