DR. JOHN JOSEPH PETOSA JR. MD
NPI 1851896526
Pediatrics - Pediatric Emergency Medicine in Syracuse, NY

Q: What is John Petosa's NPI number?

The NPI number for John Petosa is 1851896526. It was assigned to this individual provider in the NPPES registry on March 26, 2018.

Q: What is John Petosa's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Emergency Medicine, with taxonomy code 2080P0204X.

Q: When was this NPI record last updated?

The NPPES record for John Petosa was last updated on July 15, 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.

Active since March 26, 2018PECOS Enrolled

750 EAST ADAMS ST., SYRACUSE, NY 13210(315) 464-4363(315) 464-8690 Get Directions Write a Review

NPPES record last updated: July 15, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 15, 2024, Nov 1, 2021, Oct 20, 2021 and 3 more (6 updates tracked since 2018).

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About Dr. John Joseph Petosa Jr. Md NPPES

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

DR. JOHN JOSEPH PETOSA JR. MD (NPI 1851896526) is an individual pediatric emergency medicine provider in Syracuse, New York, licensed in New York (326512) and active in the NPI registry since March 2018. He is enrolled in Medicare PECOS and maintains a secondary practice location in Nashville.

NPPES Registry Identity

NPI1851896526

Entity TypeIndividualMale

Primary Taxonomy2080P0204X

Provider Legal NameDR. JOHN JOSEPH PETOSA JR.Credential: MD

Location Address750 EAST ADAMS ST.Syracuse, NY 13210-2306

Mailing Address750 East Adams St.Syracuse, NY 13210-2306 · (315) 464-4363 · Fax (315) 464-8690

Phone(315) 464-4363

Fax(315) 464-8690

Sole ProprietorNo

Enumeration DateMarch 26, 2018

Last NPPES UpdateJuly 15, 20246 updates tracked since enumeration

NPPES CertifiedMarch 30, 2022

✔ NPI 1851896526 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric Emergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code2080P0204X

Licenses✔ Licensed in NY · 326512✔ Licensed in TN · 63941

Definition

A pediatrician who has special qualifications to manage emergencies in infants and children.

750 EAST ADAMS ST., Syracuse, NY 13210

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Secondary Practice Location 1

Location 12200 Childrens Way # B319Nashville, TN 37232-9001 · Phone (615) 936-3898 · Fax (615) 936-4392

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. John Joseph Petosa Jr. Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Other Providers at the Same Location NPPES 11

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

BETTIE LOUGHREY NP

Nurse Practitioner (Psychiatric/Mental Health)