| Matthew D Petta, CRNA | |
|
628 Madison St, Port Townsend, WA 98368-4414 | |
| (402) 990-0733 | |
| Not Available |
| Full Name | Matthew D Petta |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 20 Years |
| Location | 628 Madison St, Port Townsend, Washington |
| 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 |
|---|---|---|---|
| 1376569954 | NPI | - | NPPES |
| 1376569954 | Other | WA | NPI |
| 2046617 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | AP60548506 (Washington) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 60552041 (Washington) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Washington Gastroenterology Pllc | 6204194848 | 118 |
| Entity Name | Jefferson County Public Hospital District No 2 |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356492953 PECOS PAC ID: 4789593708 Enrollment ID: O20031111000542 |
| Entity Name | Olympic Anesthesia Services, Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1275586125 PECOS PAC ID: 4587551064 Enrollment ID: O20040301000362 |
| Entity Name | Jefferson County Public Hospital District No 2 |
|---|---|
| Entity Type | Part A Provider - Critical Access Hospital |
| Entity Identifiers | NPI Number: 1356492953 PECOS PAC ID: 4789593708 Enrollment ID: O20080304000166 |
| Entity Name | Washington Gastroenterology Pllc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306364401 PECOS PAC ID: 6204194848 Enrollment ID: O20180103000884 |
| Mailing Address | Practice Location Address |
|---|---|
| Matthew D Petta, CRNA 628 Madison St, Port Townsend, WA 98368-4414 Ph: (402) 990-0733 | Matthew D Petta, CRNA 628 Madison St, Port Townsend, WA 98368-4414 Ph: (402) 990-0733 |
Patricia L Stanwood, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 834 Sheridan St, Port Townsend, WA 98368 Phone: 360-385-2200 Fax: 360-379-2242 | |
Maria Packard, Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 834 Sheridan St, Port Townsend, WA 98368 Phone: 360-385-2200 | |
Kory M Albert, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 834 Sheridan St, Port Townsend, WA 98368 Phone: 360-385-2200 | |
Brad T Walker, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 834 Sheridan St, Port Townsend, WA 98368 Phone: 360-385-2200 | |
Colum Patrick Tinley, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 834 Sheridan St, Port Townsend, WA 98368 Phone: 360-385-2200 | |
Mr. Todd A. Erickson, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 834 Sheridan St, Port Townsend, WA 98368 Phone: 360-385-2200 Fax: 360-379-2250 |