Mitchell Ryan Petty, is a medicare enrolled "Urology" physician in Carlsbad, New Mexico. His current practice location is
2420 W Pierce St Ste 102, Carlsbad, New Mexico. You can reach out to his office (for appointments etc.) via phone at
(575) 887-4100.
Mitchell Ryan Petty is licensed to practice in New Mexico (license number DO2025-0162) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1407485808.
Physician's Profile
Full Name | Mitchell Ryan Petty |
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Gender | Male |
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Speciality | Urology |
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Location | 2420 W Pierce St Ste 102, Carlsbad, New Mexico |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1407485808
- Provider Enumeration Date: 04/07/2020
- Last Update Date: 10/09/2025
Medicare PECOS Information:
- PECOS PAC ID: 0749608990
- Enrollment ID: I20200921000576
Medical Identifiers
Medical identifiers for Mitchell Ryan Petty such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1407485808 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208800000X | Urology | DO2025-0162 (New Mexico) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mitchell Ryan Petty is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Mitchell Ryan Petty, 419 W San Antonio St, Lockhart, TX 78644-2657 Ph: (512) 913-8036 | Mitchell Ryan Petty, 2420 W Pierce St Ste 102, Carlsbad, NM 88220-3517 Ph: (575) 887-4100 |
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