David P Petrie
FAXTON - ST LUKES HEALTHCARE


Address: 358 Madison St, Waterville, NY 13480-1116
Phone: 3158414973

David P Petrie (NPI# 1003900440, PAC ID# 6901852722) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.

Physician Overview

Nation Provider ID (NPI) 1003900440
PAC ID by PECOS 6901852722
Professional Enrollment ID I20050510000999
Full Name David P Petrie
Organization Legal Name FAXTON - ST LUKES HEALTHCARE
Address 358 Madison St
Waterville
NY 13480-1116
Phone Number 3158414973
Gender M
Credential MD
Medical School NEW YORK MEDICAL COLLEGE
Graduation Year 1984
Primary Specialty FAMILY MEDICINE
Secondary Specialties ADDICTION MEDICINE
Group Practice PAC ID 2769380252
Number of Group Practice Members 149
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
330044 FAXTON-ST LUKE'S HEALTHCARE
330245 ST ELIZABETH MEDICAL CENTER

Other Locations

Address Phone Organization
1676 Sunset Ave, Utica, NY 13502-5416 3156256000 FAXTON - ST LUKES HEALTHCARE
358 Madison St, Waterville, NY 13480-1116 3158414973 FAXTON - ST LUKES HEALTHCARE

Individual EP (Eligible Professionals) Public Reporting – Performance Scores
Physician Quality Reporting System (PQRS) and non-PQRS Qualified Clinical Data Registry (QCDR)

Measure Identifier Measure Title Performance Rate Reporting Mechanism
ACI_EC_TRANS_PHCDRR_1 Immunization Registry Reporting %
ACI_EC_TRANS_PPHI_1 Security Risk Analysis %

Organization Information

Organization Legal Name FAXTON - ST LUKES HEALTHCARE
Physicians 161

Physicians with the same organization

Name Specialty Organization Address
Mary-jane Elizabeth Borst Nurse Practitioner Faxton - St Lukes Healthcare 3946 Oneida St, New Hartford, NY 13413-9702
Alyssia M Lloyd Nurse Practitioner Faxton - St Lukes Healthcare 2888 Oneida St, Sauquoit, NY 13456-3110
Irena Kokot Family Medicine Faxton - St Lukes Healthcare 8411 Seneca Tpke, New Hartford Medical Office, New Hartford, NY 13413-4912
Jonathan D Wigderson Orthopedic Surgery Faxton - St Lukes Healthcare 1903 Sunset Ave, Utica, NY 13502-5617
Adam F Seigers Family Medicine Faxton - St Lukes Healthcare 13460 State Route 12, Boonville, NY 13309-3531
Mario Carrillo Vascular Surgery Faxton - St Lukes Healthcare 1676 Sunset Ave, Utica, NY 13502-5416
Nalini J Namassivaya Pulmonary Disease Faxton - St Lukes Healthcare 35 Riverside Dr, Utica, NY 13502-2320
John Sperling General Surgery Faxton - St Lukes Healthcare 1656 Champlin Ave, New Hartford, NY 13413-1068
Tatyana Misyulya Family Medicine Faxton - St Lukes Healthcare 417 Trenton Ave, Utica, NY 13502-1613
Vigneswaran Kandiah Internal Medicine Faxton - St Lukes Healthcare 101 College St, Clinton, NY 13323-1634

Office Location

Street Address 358 MADISON ST
City WATERVILLE
State NY
Zip 13480-1116

Physicians in the same location

Name Specialty Organization Address
Linda A O Connor Nurse Practitioner Faxton - St Lukes Healthcare 358 Madison St, Waterville, NY 13480-1116
Mallory J Sullivan Family Medicine Faxton - St Lukes Healthcare 358 Madison St, Waterville, NY 13480-1116
Nicole R Schreck Nurse Practitioner Faxton - St Lukes Healthcare 358 Madison St, Waterville, NY 13480-1116
Francis Chabot Family Medicine Faxton - St Lukes Healthcare 358 Madison St, Waterville, NY 13480-1116
Lara B Belfiore Nurse Practitioner Faxton - St Lukes Healthcare 358 Madison St, Waterville, NY 13480-1116
Colleen A Smith Nurse Practitioner Faxton - St Lukes Healthcare 358 Madison St, Waterville, NY 13480-1116

Physicians in the same zip code

Name Specialty Organization Address
Wayne R Chapman Chiropractic 214 E Main St, Waterville, NY 13480-1110
Shelby Sharp Nurse Practitioner Community Memorial Hospital 117 W Main St, Waterville, NY 13480-1165
Cheryl A Palmer Nurse Practitioner Community Memorial Hospital 117 W Main St, Waterville, NY 13480-1165
Michael K Walsh Family Medicine Community Memorial Hospital 117 W Main St, Waterville, NY 13480-1165

Competitor

Search similar physicians

City WATERVILLE
Zip Code 13480
Specialty FAMILY MEDICINE
City + Specialty WATERVILLE + FAMILY MEDICINE

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS)
Jurisdiction Medicare

This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.

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