IRINA SERGEEVNA PETTY PA
NPI 1619211463
Physician Assistant in Newark, OH

Q: What is Irina Petty's NPI number?

The NPI number for Irina Petty is 1619211463. It was assigned to this individual provider in the NPPES registry on November 17, 2012.

Q: What is Irina Petty's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Irina Petty was last updated on April 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.

Active since November 17, 2012PECOS EnrolledAccepts Medicare Assignment

79.35/100

CMS Quality Rating

2000 TAMARACK RD, NEWARK, OH 43055(220) 564-4650(220) 564-4238 Get Directions Write a Review

NPPES record last updated: April 2, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 2, 2021, Apr 30, 2018 (2 updates tracked since 2018).

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About Irina Sergeevna Petty Pa NPPES

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

IRINA SERGEEVNA PETTY PA (NPI 1619211463) is an individual physician assistant in Newark, Ohio, licensed in Ohio (003613) and active in the NPI registry since November 2012. She is enrolled in Medicare PECOS, is affiliated with Licking Memorial Hospital, and is a graduate of Other (2012).

NPPES Registry Identity

NPI1619211463

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameIRINA SERGEEVNA PETTYCredential: PA

Location Address2000 TAMARACK RDNewark, OH 43055

Mailing Address2000 Tamarack RdNewark, OH 43055 · (220) 564-4650 · Fax (220) 564-4238

Phone(220) 564-4650

Fax(220) 564-4238

Sole ProprietorYes

Medical School CMSOtherGraduated 2012

Enumeration DateNovember 17, 2012

Last NPPES UpdateApril 2, 20212 updates tracked since enumeration

NPPES CertifiedApril 2, 2021

✔ NPI 1619211463 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

License✔ Licensed in OH · 003613

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

2000 TAMARACK RD, Newark, OH 43055

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, MedMutual, Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Irina Sergeevna Petty Pa 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 ID4284872094

PECOS Enrollment IDI20130605000644

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.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

182 services145 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

107 services83 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

15 services15 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Licking Memorial Hospital

Acute Care Hospitals · Newark, OH

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number360218

Location1320 West Main StreetNewark, OH 43055 · Licking County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 43055 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$84.72 typical visit price

range $54.34 – $166.65

Typical copayment $21.18 (range $13.58 – $41.66)

Most-billed visit code 99203

Established Patient

$68.07 typical visit price

range $17.10 – $135.40

Typical copayment $17.01 (range $4.27 – $33.85)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

79.35/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

71.02

Promoting Interoperability

100

Improvement Activities

Cost

57.85

Other Providers at the Same Location NPPES 15

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

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