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PETER A KORETSKY MD PA
NPI 1124117791
Internal Medicine - Gastroenterology in Melbourne, FL

Active since October 12, 2006CLIA 10D2323480 · Certificate of Compliance
2955 PINEDA PLAZA WAY STE 115, MELBOURNE, FL 32940(321) 254-7375(321) 254-7145 Get Directions Write a Review

NPPES record last updated: March 28, 2014. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Peter A Koretsky Md Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PETER A KORETSKY MD PA (NPI 1124117791) is a healthcare organization registered as a gastroenterology in Melbourne, Florida and active in the NPI registry since October 2006. The organization holds a CLIA Certificate of Compliance certificate valid through May 7, 2027 and lists Peter A Koretsky, President, as its authorized official.

NPPES Registry Identity

NPI1124117791
Entity TypeOrganization
Primary Taxonomy207RG0100X
Legal Business NamePETER A KORETSKY MD PA
Location Address2955 PINEDA PLAZA WAY STE 115Melbourne, FL 32940-7306
Mailing Address2955 Pineda Plaza Way Ste 115Melbourne, FL 32940-7306 · (321) 254-7375 · Fax (321) 254-7145
Phone(321) 254-7375
Fax(321) 254-7145
Organization SubpartNo
Authorized OfficialPeter A KoretskyPresident · (321) 254-7375
Enumeration DateOctober 12, 2006
Last NPPES UpdateMarch 28, 2014
✔ NPI 1124117791 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal Medicine · GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code207RG0100X
Definition
An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs.
2955 PINEDA PLAZA WAY STE 115, Melbourne, FL 32940
Open in Google Maps ↗

Other Identifiers 2

Medicare ID-Type UnspecifiedK8748
Medicaid2734737FL

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 10D2323480

Peter A Koretsky MD PA · Melbourne, FL
Active · expires May 7, 2027
CLIA Number10D2323480
Laboratory TypePhysician Office
Certificate Effective DateMay 8, 2025
Certificate Expiration DateMay 7, 2027
Laboratory DirectorHung Lee
Laboratory Phone(321) 254-7375
Laboratory LocationPeter A Koretsky MD PA2955 Pineda Plaza Way, Melbourne, FL 32940
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SARAH BACHAND APRN
Nurse Practitioner
2955 PINEDA PLAZA WAY STE 115
MELBOURNE, FL 32940
Brevard County (321) 254-7375
DR. PETER A KORETSKY MD
Internal Medicine (Gastroenterology)
2955 PINEDA PLAZA WAY STE 115
MELBOURNE, FL 32940
Brevard County (321) 254-7375
MRS. MARY LOU KORETSKY ARNP
Nurse Practitioner (Adult Health)
2955 PINEDA PLAZA WAY STE 115
MELBOURNE, FL 32940
Brevard County (321) 254-7375

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Peter A Koretsky MD PA's NPI number?

The NPI number for Peter A Koretsky MD PA is 1124117791. It was assigned to this organization in the NPPES registry on October 12, 2006.

Where is Peter A Koretsky MD PA located?

Peter A Koretsky MD PA is located at 2955 Pineda Plaza Way Ste 115, Melbourne, FL 32940. The listed phone number is (321) 254-7375.

What is Peter A Koretsky MD PA's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Gastroenterology, with taxonomy code 207RG0100X.

Does Peter A Koretsky MD PA hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 10D2323480) is associated with this NPI, valid through May 7, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Peter A Koretsky MD PA was last updated on March 28, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.