ADAM MICHAEL PETRY (PA-C) – Physician Assistant, NPI 1154064830

ADAM MICHAEL PETRY (PA-C) is a healthcare provider. based in Berea, Ohio. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 50.008229RX (OH). The NPI Number for ADAM MICHAEL PETRY (PA-C) is 1154064830

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
ADAM MICHAEL PETRY (PA-C)
NPI
1154064830
Phone
(440) 826-8016
Address
275 Eastland Rd
Enumeration Date
19 April 2022
Last Update Date
14 August 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2023 (3 years ago)
PAC ID
5294199709
Group Practice PAC ID
3274431879
Professional Enrollment ID
I20230918002037
Address ID
OH441061716CL11100AVEX342
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:4State licenses:1Digital endpointsOther names

5,036 PHYSICIAN ASSISTANT in OH

Provider Addresses for ADAM MICHAEL PETRY (PA-C)

  • 275 Eastland Rd

    Berea, OH 440172005

    Phone: (440) 826-8016

    Type: Location

  • 275 EASTLAND RD

    BEREA, OH 440172005

    Phone: (440) 826-8016

    Type: Mailing

  • 11100 EUCLID AVE

    CLEVELAND, OH 441061716

    Phone: (216) 844-3722

    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: 2023-09-18

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
I20230918002037IPhysician AssistantOHTBD

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
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes2911$0
View full utilization report →

Insurance plans in this area (ZIP 44017)

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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: 3274431879View full group profile
NameSpecialtyState
Physician AssistantOH
Physician AssistantFL
Physician AssistantOH
Physician AssistantOH
Physician AssistantOH
Physician AssistantOH
Nurse PractitionerOH
-OH
Nurse PractitionerOH
-OH

Reviews

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Frequently asked questions

What federal number belongs to ADAM MICHAEL PETRY (PA-C)?
The federal identifier for ADAM MICHAEL PETRY (PA-C) is NPI 1154064830.
Does this profile mean ADAM MICHAEL PETRY (PA-C) is currently active?
Yes — ADAM MICHAEL PETRY (PA-C) appears active in the national provider directory.
What kind of provider is ADAM MICHAEL PETRY (PA-C)?
The page reflects Physician Assistant for ADAM MICHAEL PETRY (PA-C). Clinical services aligned with this taxonomy classification.
Where is ADAM MICHAEL PETRY (PA-C)'s primary listing?
We display Berea, Ohio because that is what the record indicates for ADAM MICHAEL PETRY (PA-C).
Is ADAM MICHAEL PETRY (PA-C) a real provider?
This page reflects official NPPES data for NPI 1154064830. Always confirm identity and privileges with the practice and licensing boards.

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