DR. ROBERT JOHN PETRELLA (NPI# 1689619835) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689619835 |
| Entity Type | Individual |
| Full Name | DR. ROBERT JOHN PETRELLA |
| Credential | M.D. |
| Practice Address |
1153 Centre St Faulkner Hospital Emergency Department Boston MA 02130-3446 |
| Mailing Address |
103 Sanborn Ave West Roxbury MA 02132-3834 |
| Practice Telephone | 6179837700 |
| Mailing Telephone | 6173236676 |
| Enumeration Date | 2006-06-19 |
| Last Update Date | 2008-07-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 75111 | MA | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 75111 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | BLUE SHIELD | J13837 | 01 |
| MA | TUFTS | 075111 | 01 |
| MA | 3110613 | 05 |
| Street Address |
1153 CENTRE ST FAULKNER HOSPITAL EMERGENCY DEPARTMENT |
| City | BOSTON |
| State | MA |
| Zip Code | 02130-3446 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811995806 | Eleanor C Pitts | Plastic Surgery | 1153 Centre St, Suite 5790, Boston, MA 02130-3446 | 2005-07-13 |
| 1720614902 | Connie Hoi Lio | Pharmacist | 1153 Centre St, Boston, MA 02130-3446 | 2020-03-19 |
| 1558908699 | Emily Gill | Social Worker | 1153 Centre St, Boston, MA 02130-3446 | 2019-12-09 |
| 1740824531 | Kelly Ann Flanagan | Dietitian, Registered | 1153 Centre St, Boston, MA 02130-3446 | 2019-11-05 |
| 1548726870 | Caitlin Losi | Physician Assistant | 1153 Centre St, Boston, MA 02130-3446 | 2019-02-12 |
| 1598240251 | Audrey Claire Steffano | Social Worker | 1153 Centre St, Boston, MA 02130-3446 | 2018-09-28 |
| 1629552062 | Nicolas Mcqueen | Social Worker | 1153 Centre St, Psychiatry 2nd Floor, Boston, MA 02130-0213 | 2018-09-21 |
| 1174007066 | Elyse Joelle Yarmosky | Social Worker | 1153 Centre St, Boston, MA 02130-3446 | 2018-09-18 |
| 1356841407 | Matt Hoffman | Specialist/Technologist | 1153 Centre St, Boston, MA 02130-3446 | 2018-02-15 |
| 1740797414 | Andrea Guarente | Nurse Practitioner | 1153 Centre St, Boston, MA 02130-3446 | 2018-01-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952913121 | Virginia Dawn Pratt | Social Worker | Ethos, 555 Amory Street, Jamaica Plain, MA 02130 | 2020-08-19 |
| 1689139917 | Lina Skiba | Speech-Language Pathologist | Thom Child & Family Services, 555 Armory St, Jamaica Plain, MA 02130 | 2019-01-31 |
| 1841775442 | Melissa Rocklen | Social Worker | 30 Germania St Bldg C, Jamaica Plain, MA 02130 | 2018-09-28 |
| 1902389281 | Susan N. Berkman | Social Worker | 111 Perkins St., Apt.120, Jamaica Plain, MA 02130 | 2018-09-12 |
| 1326551912 | Cindy Tromp | Counselor | Arbour Hospital, 49 Robinwood Ave, Jamaica Plain, MA 02130 | 2017-11-06 |
| 1811415128 | Jesse Myles Carmen | Social Worker | 555 Armory Street, Jamaica Plain, MA 02130 | 2017-09-07 |
| 1881119410 | Melanie Suzanne Witman | Counselor | 1125 Centre Street, Boston, MA 02130 | 2017-08-04 |
| 1740702125 | Farah Clermont | Counselor | 3815 Washington St., Jamaica Plain, MA 02130 | 2017-07-07 |
| 1346777554 | Anjalie L Pieres | Counselor | 157 Green Streey, Jamaica Plain, MA 02130 | 2017-05-18 |
| 1316480098 | Caroline Amina Shaw-moss | Counselor | 7 Burr St., Boston, MA 02130 | 2016-11-29 |
| Find all providers in zip 02130 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366947954 | Karrin Weisenthal | Emergency Medicine | 1 Boston Pl Rm 1322, Boston, MA 02108 | 2018-03-27 |
| 1942705884 | Jillian Britt Duffy | Emergency Medicine | 1 Boston Medical Ctr Pl Rm 1322, Boston, MA 02118 | 2018-03-23 |
| 1245760024 | Nicholas D. Kurtzman | Emergency Medicine | One Deaconess Road Rosenberg Building, 2nd Floor, Department of Emergency Medicine, Boston, MA 02215 | 2017-06-14 |
| 1942730007 | Alec John Koffer | Emergency Medicine | 1 Deaconess Rd Bldg 2nd, Boston, MA 02215-5321 | 2017-06-12 |
| 1609257609 | Andrew Dean Alex Marshall | Emergency Medicine | 1 Deaconess Rd Fl 2, Boston, MA 02215-5321 | 2015-06-16 |
| 1124414446 | Alister Martin | Emergency Medicine | 75 Francis St # At, Boston, MA 02115-6110 | 2015-04-14 |
| 1699188524 | Vijay Christopher Kannan | Emergency Medicine | 1 Deaconess Road W/cc2, Boston, MA 02215 | 2014-06-09 |
| 1659798809 | Jonathan Van Ornam | Emergency Medicine | 75 Francis St # 236a, Boston, MA 02115-6110 | 2014-03-26 |
| 1871938597 | Christine Lee | Emergency Medicine | Department of Emergency Medicine, Beth Israel Deaconess, One Deaconess Road, Rosenberg Building 2, Boston, MA 02215-5321 | 2013-05-08 |
| 1497098149 | Andrew Perechocky | Emergency Medicine | 1 Boston Medical Center Place, Dowling 1 South Rm 1322, Boston Medical Center, Dept. of Emergency Medicine, Boston, MA 02118 | 2013-04-01 |
| Find all providers in BOSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.