William Alfred Pettit III, MD

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

17635 Issued in OR

Practice address

1404 Gekeler Lane
La Grande, OR 97850

Phone

(541) 963-3119

Fax

(541) 963-3110

NPI assigned

Sep 20, 2006

Last updated

Mar 5, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

• William Pettit Professional name

Medicare fee-for-service enrollment

Enrolled in OR

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 1

Specialty

Ophthalmology

Education

University of Texas Medical School at Houston, 1987

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Grande Ronde Hospital Hospital, La Grande, OR, CCN 381321

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

• Grande Ronde Hospital

  dba Grande Ronde Hospital Childrens Clinic

  • Pediatrics Physician
  • La Grande, OR
  • NPI 1861434615

  Hospital

  Care Compare affiliation
• Grande Ronde Hospital Inc.

  dba Grande Ronde Hospital Womens Clinic

  • Obstetrics & Gynecology Physician
  • La Grande, OR
  • NPI 1972545895

  Hospital

  Care Compare affiliation
• Grande Ronde Hospital, Inc.

  dba Grande Ronde Hospital Internal Medicine Clinic

  • Primary Care Clinic/Center
  • La Grande, OR
  • NPI 1174553929

  Hospital

  Care Compare affiliation
• Grande Ronde Hospital, Inc.

  • Critical Access Hospital
  • La Grande, OR
  • NPI 1467446195
  Care Compare affiliation

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393977600000",
    "number": "1942308473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1404 GEKELER LANE",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "97850",
            "telephone_number": "541-963-3119",
            "fax_number": "541-963-3110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 GEKELER LANE",
            "city": "LA GRANDE",
            "state": "OR",
            "postal_code": "97850",
            "telephone_number": "541-963-3119",
            "fax_number": "541-963-3110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIT",
        "first_name": "WILLIAM",
        "middle_name": "ALFRED",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2014-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "OR",
            "license": "17635",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "044607",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WILLIAM",
            "last_name": "PETTIT",
            "credential": "MD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Brandi Ann Perry, RN
• Margaret Gerba Perry, N.D.
• Megan Petersen
• Bailey M Petredis
• Joseph Louis Petrusek, M.D., P.C.
• Katherine Pfister-Minogue, RN, BSN, MSN, ANP
• Karen Phelps, FNP
• Tanya Marie Phillips
• Steven K Pinther, D.O.
• Mary Grace Porter, D.O

• Ophthalmology Physician in La Grande, OR
• Providers in La Grande, OR by specialty
• Ophthalmology Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2014; 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.