MR. CHAD WALTER PETTIES SR.
NPI 1528398971
Marriage & Family Therapist in Mira Loma, CA
About Mr. Chad Walter Petties Sr. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MR. CHAD WALTER PETTIES SR. (NPI 1528398971) is an individual marriage & family therapist in Mira Loma, California, licensed in California (92433) and active in the NPI registry since January 2010. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mr. Chad Walter Petties Sr. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Chad Petties reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
San Jose, CA 95113
- Reassigned Medicare billing, California enrollment
- 3,139 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 5
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
JURUPA VALLEY, CA 91752
MIRA LOMA, CA 91752
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 Chad Petties's NPI number?
The NPI number for Chad Petties is 1528398971. It was assigned to this individual provider in the NPPES registry on January 7, 2010.
Where is Chad Petties located?
Chad Petties practices at 10551 Bellegrave Ave, Mira Loma, CA 91752. The listed phone number is (951) 488-2938.
What is Chad Petties's specialty?
The primary specialty registered for this NPI is Marriage & Family Therapist with taxonomy code 106H00000X.
Is Chad Petties enrolled in Medicare?
Yes. Chad Petties is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Chad Petties's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Chad Petties reassigns Medicare benefits to Grow Healthcare Group PC (San Jose, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Chad Petties's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Chad Petties was last updated on September 12, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Mr. Chad Walter Petties Sr. · NPI 1528398971
Marriage & Family Therapist provider in Mira Loma, California. Individual provider, active in the CMS NPPES registry since January 7, 2010.
## Identity
- **NPI:** 1528398971 (Entity type: Individual)
- **Enumerated:** January 7, 2010
- **Primary specialty:** Marriage & Family Therapist · taxonomy 106H00000X
- **State license:** 92433 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 10551 BELLEGRAVE AVE, Mira Loma, CA 91752-1800
- **Phone:** (951) 488-2938
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Grow Healthcare Group PC (NPI 1154994846, San Jose, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 12, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1528398971) · Data from the CMS NPPES public registry.