NORMAN CHARLES PETTY (MD) – Family Medicine Physician, NPI 1235166216

NORMAN CHARLES PETTY (MD) is a healthcare provider. based in Ketchikan, Alaska. specializing in EMERGENCY MEDICINE, FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. M8408 (ID). The NPI Number for NORMAN CHARLES PETTY (MD) is 1235166216

Main info

Male
26 Years Of Experience
Accepts Medicare Assignment
Name
NORMAN CHARLES PETTY (MD)
NPI
1235166216
Phone
(907) 225-5171
Address
3100 Tongass Ave
Enumeration Date
27 June 2006
Last Update Date
10 March 2025

Doctor Profile

Medical School Name
UNIVERSITY OF MISSOURI, COLUMBIA SCHOOL OF MEDICINE
Secondary Phone
9074863281
Graduation Year
2000 (26 years ago)
PAC ID
0840270773
Group Practice PAC ID
5799675120
Professional Enrollment ID
I20230614003456
Address ID
AK996156602KO1915XDRXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience80
Completeness75
Years active:19State licenses:3Digital endpointsOther names

151 EMERGENCY MEDICINE in AK

Provider Addresses for NORMAN CHARLES PETTY (MD)

  • 3100 Tongass Ave

    Ketchikan, AK 999015746

    Phone: (907) 225-5171

    Type: Location

  • Alaska Native Medical Center Hospital, 4315, Diplomacy Drive, Anchorage, Alaska, 99508, United States

    ANCHORAGE, AK 995085926

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-06-14

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 7 Medicare enrollment records; no due dates published yet.

Enrollment records

7

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040722000036IFamily PracticeAKTBD
I20060224000441IEmergency MedicineWYTBD
I20060810000166IEmergency MedicineKSTBD
I20080711000549IEmergency MedicineMOTBD
I20131028000652IEmergency MedicineOKTBD
I20131217001333IEmergency MedicineTXTBD
I20230614003456IEmergency MedicineAKTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 99901)

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Provider's Procedures

NORMAN CHARLES PETTY (MD) performs procedures in EMERGENCY MEDICINE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
EMERGENCY MEDICINEAK93010Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report9588

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5799675120View full group profile
NameSpecialtyState
-WA
General SurgeryOK
Cardiovascular Disease (Cardiology)AK
Internal MedicineAK
Family PracticeCA
Family PracticeWA
Emergency MedicineAK
Cardiovascular Disease (Cardiology)AK
Family PracticeAK
Family PracticeOR

Reviews

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Frequently asked questions

What federal number belongs to NORMAN CHARLES PETTY (MD)?
The federal identifier for NORMAN CHARLES PETTY (MD) is NPI 1235166216.
Is NORMAN CHARLES PETTY (MD)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize NORMAN CHARLES PETTY (MD)'s specialty in plain language?
Clinically, the directory lists NORMAN CHARLES PETTY (MD) with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for NORMAN CHARLES PETTY (MD)?
The page summarizes Ketchikan, Alaska for NORMAN CHARLES PETTY (MD); expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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Unknown Individual

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NPI: 1003846197