Petra Medicare Transportation LLC

Primary specialty

Non-emergency Medical Transport (VAN)Taxonomy code 343900000X

Legal business name

PETRA MEDICARE TRANSPORTATION LLC

Practice address

1425 W Kemper Rd
Cincinnati, OH 45240-1630

Phone

(513) 405-6765

NPI assigned

Jan 15, 2020

Organization subpart

No

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

Authorized official

Name

Ibrahim KakishNPI 1073151841

Title

Owner

Phone

(513) 405-6765

Specialties & licenses 1

Addresses

Other names 1

• petra medicare transportation llc Doing business as

Practitioners 1

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

• Ibrahim Kakish

  • Counselor
  • Cincinnati, OH
  • NPI 1073151841
  NPD Authorized official

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

{
    "created_epoch": "1579046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579046400000",
    "number": "1962042192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 W KEMPER RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452401630",
            "telephone_number": "513-405-6765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1425 W KEMPER RD",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452401630",
            "telephone_number": "513-405-6765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETRA MEDICARE TRANSPORTATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-15",
        "last_updated": "2020-01-15",
        "certification_date": "2020-01-15",
        "status": "A",
        "authorized_official_last_name": "KAKISH",
        "authorized_official_first_name": "IBRAHIM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "513-405-6765"
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "petra medicare transportation llc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Susan Thayer Peterson, CPRS
• Lisa Kay Petiniot, M.D.
• Alexandra P Petit
• Elena Petkovska, MD
• Petr Vaughan, DDS, LLC
• Vanessa Ann Petranek
• Jessica Sue Petre, MSW, LISW
• Haley Petrey, OTR/L
• Lisa Jayne Petrey, B.A,
• Amanda Petric, LISW-S

• Non-emergency Medical Transport (VAN) in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Non-emergency Medical Transport (VAN) in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2020; 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.