Tamara Piroska Petrac-Halatsis, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

53965 Issued in MN

Practice address

5200 Fairview Boulevard
OB/GYN Department
Wyoming, MN 55092

Phone

(651) 982-7670

Fax

(651) 982-7675

NPI assigned

May 22, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Dr. Tamara Piroska Petrac Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Florida Medical Practice Plan Inc

  • General Practice Physician
  • Tallahassee, FL
  • NPI 1326386293
  NPD (past)

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320796800000",
    "number": "1902851876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 FAIRVIEW BOULEVARD",
            "city": "WYOMING",
            "state": "MN",
            "postal_code": "55092",
            "telephone_number": "651-982-7670",
            "fax_number": "651-982-7675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 FAIRVIEW BOULEVARD",
            "address_2": "OB/GYN DEPARTMENT",
            "city": "WYOMING",
            "state": "MN",
            "postal_code": "55092",
            "telephone_number": "651-982-7670",
            "fax_number": "651-982-7675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRAC-HALATSIS",
        "first_name": "TAMARA",
        "middle_name": "PIROSKA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2011-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "ME94155",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MN",
            "license": "53965",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274695600",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAMARA",
            "last_name": "PETRAC",
            "middle_name": "PIROSKA",
            "prefix": "DR.",
            "credential": "MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Joseph R Pasquarella, MD
• David Charles Paulsen, PHARM D.
• Holly Payer, PT
• Teresa Pederson
• Erik Jordan Peterson, MD
• Pfeiffer Chiropractic Clinic, Inc.
• Brenda Kay Pfeiffer, DC
• Luther P Philaya, MD
• Katelyn Plohasz, MS-CCC
• Darryl R Quiram, MD

• Obstetrics & Gynecology Physician in Wyoming, MN
• Providers in Wyoming, MN by specialty
• Obstetrics & Gynecology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2011; 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.