Kyle Gregory Petras, BSW

Primary specialty

School Social WorkerTaxonomy code 1041S0200X

License

13466-120 Issued in WI

Practice address

700 Regent St Ste 302
Madison, WI 53715-2634

Phone

(608) 441-3290

NPI assigned

Nov 3, 2022

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Dane County Counseling Services SC

  • Mental Health Counselor
  • Madison, WI
  • NPI 1346131174
  NPD
• Group Health Cooperative of South Central Wisconsin

  • Health Maintenance Organization
  • Madison, WI
  • NPI 1245260165
  NPD (past)

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

{
    "created_epoch": "1667433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1982311478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 REGENT ST STE 302",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537152634",
            "telephone_number": "608-441-3290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 REGENT ST STE 302",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537152634",
            "telephone_number": "608-441-3290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRAS",
        "first_name": "KYLE",
        "middle_name": "GREGORY",
        "credential": "BSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-11-03",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "WI",
            "license": "13466-120",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzan Rae Peterson, LPN
• Tracy Peterson, RN
• Tyler Peterson, LPC
• Katrina Petkus
• Heather M Peto, MD
• Tamara Petre, RN
• Angela Petrie, M.D.
• Rachel Lillian Petro, MD
• Karen Marie Petrow
• Joseph J Petrozzo, PAC

• School Social Worker in Madison, WI
• Providers in Madison, WI by specialty
• School Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2022; 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.