TIMOTHY PETROSKY (PA) – Physician Assistant, NPI 1609844208

TIMOTHY PETROSKY (PA) is a healthcare provider. based in Grand rapids, Michigan. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 5601003397 (MI). The NPI Number for TIMOTHY PETROSKY (PA) is 1609844208

Main info

Male
26 Years Of Experience
Accepts Medicare Assignment
Name
TIMOTHY PETROSKY (PA)
NPI
1609844208
Phone
(616) 940-0660
Address
61 COMMERCE AVE SW
Enumeration Date
9 March 2006
Last Update Date
21 April 2009

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7342596015
Graduation Year
2000 (26 years ago)
PAC ID
6406846757
Group Practice PAC ID
0547440745
Professional Enrollment ID
I20040517001541
Address ID
MI481521006LI39000RDXX440
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

6,069 PHYSICIAN ASSISTANT in MI

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Provider Addresses for TIMOTHY PETROSKY (PA)

  • 61, Commerce Avenue Southwest, Grand Rapids, Kent County, Michigan, 49503, United States

    GRAND RAPIDS, MI 49503

    Phone: (616) 940-0660

    Fax: (616) 940-1965

    Type: Mailing

  • Providence Parkway, Novi, Oakland County, Michigan, 48374:48393, United States

    SUITE 260

    NOVI, MI 48374

    Phone: (248) 735-8272

    Fax: (248) 735-7276

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 124 Open Payments records for all available years, with a total value of $2,929.

Total Amount is formed as General ($2,929) + Research ($0) + Ownership ($0) = $2,929.

Last reported payment date: 2024-12-17 • Largest payer in this snapshot: Boston Scientific Corporation ($815).

Total Amount

$2,929

General + Research + Ownership

Payments

124

Total payment records

General Amount

$2,929

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-17

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2004-05-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

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
I20040517001541IPhysician AssistantMITBD

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
99214Established patient office or other outpatient visit, 30-39 minutes4727$0
View full utilization report →

Insurance plans in this area (ZIP 49503)

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Provider's Procedures

TIMOTHY PETROSKY (PA) performs procedures in PHYSICIAN ASSISTANT. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICIAN ASSISTANTMI20610Aspiration and/or injection of large joint or joint capsule1612

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: 0547440745View full group profile
NameSpecialtyState
Physician AssistantMI
-MI
Physician AssistantMI
Physician AssistantMI
Anesthesiology, Interventional Pain ManagementMI
Physician AssistantMI

Reviews

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Frequently asked questions

Can I verify TIMOTHY PETROSKY (PA) with an NPI only?
You can start verification with NPI 1609844208 for TIMOTHY PETROSKY (PA), then check state licensing separately.
Does CMS list TIMOTHY PETROSKY (PA) as active?
Yes — TIMOTHY PETROSKY (PA) is active in the NPI listing used on this page.
What is TIMOTHY PETROSKY (PA)'s primary classification?
Physician Assistant is the headline specialty for TIMOTHY PETROSKY (PA) here. Clinical services aligned with this taxonomy classification.
What address line appears for TIMOTHY PETROSKY (PA)?
TIMOTHY PETROSKY (PA)'s geographic hint is Grand Rapids, Michigan in our summary view.
Why does TIMOTHY PETROSKY (PA) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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