NPIMap

Organization Active NPI

Petreccia and Trotter Medical Corporation

Doing business as Infectious Disease Consultants Med. Office, Inc.

  • Infectious Disease Physician
  • Placentia, CA
National Provider Identifier
1912062647
Registry record updated Nov 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
G65207 Issued in CA
Legal business name
PETRECCIA AND TROTTER MEDICAL CORPORATION
Doing business as
Infectious Disease Consultants Med. Office, Inc.
Practice address
1275 N. Rose Drive
Suite 134
Placentia, CA 92870-3919
Phone
(714) 996-6500
Fax
(714) 996-1722
NPI assigned
Dec 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2019

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

Authorized official

Name
Joel A. Trotter, M.D.NPI 1578690343
Title
President
Phone
(714) 996-6500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RI0200X G65207 CA Primary

Addresses

Primary practice location

1275 N. Rose Drive
Suite 134
Placentia, CA 92870-3919

Mailing address

1275 N. Rose Drive
Suite 134
Placentia, CA 92870-3919
Phone (714) 996-6500

Other identifiers 2

IdentifierTypeStateIssuer
W15729OtherPROVIDER IDENTIFICATION NUMBER
GR0048130MedicaidCA

Other names 1

  • Infectious Disease Consultants Med. Office, Inc. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080501000541 CA Part B Supplier - Clinic/Group Practice 7315026309 Receives reassigned benefits from 3 practitioners
Practice locations: Placentia, CA

National Provider Directory

National Provider Directory

Locations

1275 N Rose Dr
Ste 134
Placentia, CA 92870
Phone (714) 996-6500

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1572825600000",
    "number": "1912062647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 N. ROSE DRIVE",
            "address_2": "SUITE 134",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928703919",
            "telephone_number": "714-996-6500",
            "fax_number": "714-996-1722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 N. ROSE DRIVE",
            "address_2": "SUITE 134",
            "city": "PLACENTIA",
            "state": "CA",
            "postal_code": "928703919",
            "telephone_number": "714-996-6500",
            "fax_number": "714-996-1722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETRECCIA AND TROTTER MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-22",
        "last_updated": "2019-11-04",
        "status": "A",
        "authorized_official_last_name": "TROTTER",
        "authorized_official_first_name": "JOEL",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-996-6500",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "CA",
            "license": "G65207",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER IDENTIFICATION NUMBER",
            "identifier": "W15729",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0048130",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Infectious Disease Consultants Med. Office, Inc.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Infectious Disease Consultants Med. Office, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Placentia, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.