Robert Ara Petrossian, MD

Primary specialty

Urology PhysicianTaxonomy code 208800000X

License

2023045072 Issued in MO

Practice address

12855 N 40 Dr Ste 375
Saint Louis, MO 63141-8657

Phone

(314) 567-6071

NPI assigned

Jun 12, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MO, IL2 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

Urology

Education

Oakland Univ, William Beaumont School of Medicine, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Urology of St Louis IncGroup PAC ID 6204723786, 112 clinicians

Osf Multi-Specialty GroupGroup PAC ID 3678889789, 2,123 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• HSHS St Elizabeth'S Hospital Hospital, O Fallon, IL, CCN 140187
• Anderson Hospital Hospital, Maryville, IL, CCN 140289
• Osf Saint Anthony'S Health Center Hospital, Alton, IL, CCN 140052
• St Josephs Hospital Hospital, Breese, IL, CCN 140145
• St Lukes Hospital Hospital, Chesterfield, MO, CCN 260179

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: rpetrossian742183@direct.memorialcare.org
• Direct secure messaging: robert.petrossian@490083655483396.direct.elationemr.com
• Direct secure messaging: robertpetrossian@slus.allscriptsdirect.net

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.

• Urology of St. Louis, Inc.

  • Specialist
  • Saint Louis, MO
  • NPI 1528017191

  IL, Urology

  Medicare reassignment Care Compare group NPD
• Osf Multi-Specialty Group

  • Internal Medicine Physician
  • Peoria, IL
  • NPI 1922445527
  Medicare reassignment Care Compare group NPD
• Associates in Urology a Medical Corporation

  • Urology Physician
  • Los Alamitos, CA
  • NPI 1841202074
  NPD
• Central PA Pharmacy LLC.

  • Community/Retail Pharmacy
  • Patton, PA
  • NPI 1578541413
  NPD
• Urology of St. Louis, Inc.

  • Specialist
  • O Fallon, IL
  • NPI 1265392476
  NPD
• Urology of St. Louis, Inc.

  • Urology Physician
  • Fairview Heights, IL
  • NPI 1528901287
  NPD (past)

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

• St. Lukes Episcopal-Presbyterian Hospital

  • General Acute Care Hospital
  • Chesterfield, MO
  • NPI 1346251543
  Care Compare affiliation
• Anderson Hospital

  • General Acute Care Hospital
  • Maryville, IL
  • NPI 1053481630
  Care Compare affiliation
• Osf Healthcare System

  • General Acute Care Hospital
  • Alton, IL
  • NPI 1710396932
  Care Compare affiliation
• St Elizabeths Hospital of the Hospital Sisters of the Third Order

  • General Acute Care Hospital
  • O Fallon, IL
  • NPI 1629057302
  Care Compare affiliation
• St Josephs Hospital Breese of the Hospital Sisters of the Third Orde

  • Rural Health Clinic/Center
  • Breese, IL
  • NPI 1013002658

  Hospital

  Care Compare affiliation
• St Josephs Hospital Breese of the Hospital Sisters of the Third Orde

  • General Acute Care Hospital
  • Breese, IL
  • NPI 1457319154
  Care Compare affiliation

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

{
    "created_epoch": "1497225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699401600000",
    "number": "1912436015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12855 N 40 DR STE 375",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418657",
            "telephone_number": "314-567-6071",
            "fax_number": "562-735-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12855 N 40 DR STE 375",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418657",
            "telephone_number": "314-567-6071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3 Saint Elizabeth Blvd Ste 3200",
            "address_purpose": "LOCATION",
            "city": "O Fallon",
            "state": "IL",
            "postal_code": "622691281",
            "country_code": "US",
            "telephone_number": "618-489-8030",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "326 Fountains Pkwy",
            "address_purpose": "LOCATION",
            "city": "Fairview Heights",
            "state": "IL",
            "postal_code": "622082041",
            "country_code": "US",
            "telephone_number": "618-277-3109",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETROSSIAN",
        "first_name": "ROBERT",
        "middle_name": "ARA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-12",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MO",
            "license": "2023045072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Ann Petroline, PHARM D
• Giulia Eva Maria Petrone, MD
• Jessica S Petrone, MD
• Emiko Petrosky, M.D.
• Tatyana Petrosova, MD
• Mirjana Petrovic Elbaz, MD
• Jack Parker Petrucci
• Orlando Petrucci, MD
• Zachary Michael Petruso, DC
• Nicole Marie Petrykowski, FNP

• Urology Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Urology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 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.