DR. ROBERT JOHN PETRELLA (M.D.) – Emergency Medicine Physician, NPI 1689619835

DR. ROBERT JOHN PETRELLA (M.D.) is a healthcare provider. based in West roxbury, Massachusetts. specializing in EMERGENCY MEDICINE, INTERNAL MEDICINE. They hold the professional credentials M.D.. They hold a License No. 75111 (MA). The NPI Number for DR. ROBERT JOHN PETRELLA (M.D.) is 1689619835

Main info

Male
Sole Proprietor
36 Years Of Experience
Accepts Medicare Assignment
Name
DR. ROBERT JOHN PETRELLA (M.D.)
NPI
1689619835
Phone
(617) 323-6676
Address
103 SANBORN AVE
Enumeration Date
19 June 2006
Last Update Date
1 July 2008

Doctor Profile

Medical School Name
ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI
Secondary Phone
4014563000
Graduation Year
1990 (36 years ago)
PAC ID
7618910332
Group Practice PAC ID
9739487562
Professional Enrollment ID
I20160609002360
Address ID
RI029045113NO200XXAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience57
Completeness75
Years active:19State licenses:1Digital endpointsOther names

1,682 EMERGENCY MEDICINE in MA

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Provider Addresses for DR. ROBERT JOHN PETRELLA (M.D.)

  • 103, Sanborn Avenue, West Roxbury, Boston, Suffolk County, Massachusetts, 02132, United States

    WEST ROXBURY, MA 021323834

    Phone: (617) 323-6676

    Type: Mailing

  • Brigham & Women's Faulkner Hospital, 1153, Centre Street, Jamaica Plain, Boston, Suffolk County, Massachusetts, 02130, United States

    FAULKNER HOSPITAL EMERGENCY DEPARTMENT

    BOSTON, MA 021303446

    Phone: (617) 983-7700

    Type: Location

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: 2016-06-09

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 2 Medicare enrollment records; no due dates published yet.

Enrollment records

2

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
I20050603000604IEmergency MedicineMATBD
I20160609002360IEmergency MedicineRITBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making8482$0
99284Emergency department visit with moderate level of medical decision making2828$0
99283Emergency department visit with low level of medical decision making1717$0
View full utilization report →

Insurance plans in this area (ZIP 02132)

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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: 9739487562View full group profile
NameSpecialtyState
Emergency MedicineRI
Nurse PractitionerRI
Emergency MedicineRI
Emergency MedicineNY
-RI
Emergency MedicineRI
Emergency MedicineFL
Emergency MedicineOH
Emergency MedicineRI
Emergency MedicineRI

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Frequently asked questions

Where can patients find DR. ROBERT JOHN PETRELLA (M.D.)'s NPI?
You can confirm DR. ROBERT JOHN PETRELLA (M.D.) with NPI 1689619835; it appears in the national provider directory.
Is DR. ROBERT JOHN PETRELLA (M.D.) active in the national directory?
DR. ROBERT JOHN PETRELLA (M.D.)'s public NPI profile is in an active state.
Does DR. ROBERT JOHN PETRELLA (M.D.) list a primary specialty?
If you are matching referrals, note Emergency Medicine Physician for DR. ROBERT JOHN PETRELLA (M.D.). Clinical services aligned with this taxonomy classification.
What location metadata exists for DR. ROBERT JOHN PETRELLA (M.D.)?
The page summarizes West Roxbury, Massachusetts for DR. ROBERT JOHN PETRELLA (M.D.); expand the address list for detail.
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