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MR. GARY MICHAEL PETRUS MD
NPI 1568525806
Surgery - Plastic and Reconstructive Surgery in N Little Rock, AR

Active since December 18, 2006PECOS EnrolledAccepts Medicare Assignment
4137 JOHN F KENNEDY BLVD STE A, N LITTLE ROCK, AR 72116(501) 614-3052(501) 614-3057 Get Directions Write a Review

NPPES record last updated: January 25, 2019. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Mr. Gary Michael Petrus Md NPPES

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

MR. GARY MICHAEL PETRUS MD (NPI 1568525806) is an individual plastic and reconstructive surgery provider in N Little Rock, Arkansas, licensed in Arkansas (C7318) and active in the NPI registry since December 2006. He is enrolled in Medicare PECOS, maintains a secondary practice location in North Little Rock, and is a graduate of University Of Arkansas College Of Medicine (1987).

NPPES Registry Identity

NPI1568525806
Entity TypeIndividualMale
Primary Taxonomy2086S0122X
Provider Legal NameMR. GARY MICHAEL PETRUSCredential: MD
Location Address4137 JOHN F KENNEDY BLVD STE AN Little Rock, AR 72116-8230
Mailing AddressPo Box 241580Little Rock, AR 72223-0011 · (501) 614-3052 · Fax (501) 614-3057
Phone(501) 614-3052
Fax(501) 614-3057
Sole ProprietorNo
Medical School CMSUniversity Of Arkansas College Of MedicineGraduated 1987
Enumeration DateDecember 18, 2006
Last NPPES UpdateJanuary 25, 2019
✔ NPI 1568525806 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtySurgery · Plastic and Reconstructive SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code2086S0122X
License✔ Licensed in AR · C7318
Definition
A surgeon who specializes in plastic and reconstructive surgery.
Also ListedPlastic Surgery · Plastic Surgery Within the Head and NeckTaxonomy 2082S0099X · License C7318 (AR)
4137 JOHN F KENNEDY BLVD STE A, N Little Rock, AR 72116
Open in Google Maps ↗

Secondary Practice Location 1

Location 12504 McCain Blvd, Ste 114North Little Rock, AR 72116 · Phone (501) 758-9800 · Fax (501) 758-0199

Other Identifiers 1

Medicaid114482001AR

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Gary Michael Petrus Md is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3971532599
PECOS Enrollment IDI20110228000695
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Gary Petrus reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Gary M Petrus MD PA
4.2 mi
Plastic and Reconstructive Surgery
2504 MCCAIN BLVD, SUITE 114
North Little Rock, AR 72116
  • Reassigned Medicare billing, Arkansas enrollment
NPI 1871666446 (501) 758-9800

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Gary Petrus's NPI number?

The NPI number for Gary Petrus is 1568525806. It was assigned to this individual provider in the NPPES registry on December 18, 2006.

Where is Gary Petrus located?

Gary Petrus practices at 4137 John F Kennedy Blvd Ste A, N Little Rock, AR 72116. The listed phone number is (501) 614-3052.

What is Gary Petrus's specialty?

The primary specialty registered for this NPI is Surgery, specializing in Plastic and Reconstructive Surgery, with taxonomy code 2086S0122X.

Is Gary Petrus enrolled in Medicare?

Yes. Gary Petrus is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Gary Petrus's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Gary Petrus reassigns Medicare benefits to Gary M Petrus MD PA (North Little Rock, AR). 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 Gary Petrus's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Gary Petrus accept?

Health plans from Ambetter Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 4 other insurers list Gary Petrus as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Gary Petrus was last updated on January 25, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.