| Michael Petrucci, MD | |
|
2222 N Nevada Ave, Colorado Springs, CO 80907-6819 | |
| (719) 593-1799 | |
| (719) 265-3794 |
| Full Name | Michael Petrucci |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 28 Years |
| Location | 2222 N Nevada Ave, Colorado Springs, Colorado |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609075811 | NPI | - | NPPES |
| 39020000X | Other | NJ | MONMOUTH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | DR.0054385 (Colorado) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Parkview Regional Medical Center | Fort wayne, IN | Hospital |
| Parkview Noble Hospital | Kendallville, IN | Hospital |
| Parkview Whitley Hospital | Columbia city, IN | Hospital |
| Parkview Wabash Hospital, Inc | Wabash, IN | Hospital |
| Parkview Huntington Hospital | Huntington, IN | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| P.e.t. Imaging Services, Llc | 2668412842 | 8 |
| Fort Wayne Radiology Associates Llc | 5294624060 | 33 |
| Fort Wayne Radiology Associates Llc | 5294624060 | 33 |
| Community Hospitals And Wellness Centers | 7517878093 | 28 |
| Entity Name | Fort Wayne Radiology Associates Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063475861 PECOS PAC ID: 5294624060 Enrollment ID: O20040329000698 |
| Entity Name | Breast Diagnostic Center Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1790748499 PECOS PAC ID: 9335189513 Enrollment ID: O20050506000308 |
| Entity Name | P.e.t. Imaging Services, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1992768691 PECOS PAC ID: 2668412842 Enrollment ID: O20050506000346 |
| Mailing Address | Practice Location Address |
|---|---|
| Michael Petrucci, MD Po Box 2989, Colorado Springs, CO 80901-2989 Ph: (719) 593-1799 | Michael Petrucci, MD 2222 N Nevada Ave, Colorado Springs, CO 80907-6819 Ph: (719) 593-1799 |
Dr. Courtney Todd Tripp, DO Radiology Medicare: Accepting Medicare Assignments Practice Location: 3050 Richfield Dr, Colorado Springs, CO 80919 Phone: 719-445-2282 | |
Dr. Fahim Hashmi, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 2222 N Nevada Ave, Colorado Springs, CO 80907 Phone: 516-562-0100 | |
Dr. Barry Lee Gardner, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 1644 Medical Center Pt, Suite 100, Colorado Springs, CO 80907 Phone: 719-247-5500 Fax: 719-247-5437 | |
Dr. John B Campbell, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 2222 N Nevada Ave, Colorado Springs, CO 80907 Phone: 719-593-1799 Fax: 719-265-3794 | |
Dr. Jon F Snider, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 2222 N Nevada Ave, Colorado Springs, CO 80907 Phone: 719-593-1799 Fax: 719-265-3794 | |
John L Sherman, M.D. Radiology Medicare: Medicare Enrolled Practice Location: 69 W Boulder St, Colorado Springs, CO 80903 Phone: 719-389-1106 Fax: 719-389-1180 | |
Dr. John E Schiller, M.D. Radiology Medicare: Not Enrolled in Medicare Practice Location: 2222 N Nevada Ave, Suite 101, Colorado Springs, CO 80907 Phone: 719-776-5281 Fax: 719-471-9314 |