IRINA SERGEEVNA PETTY (PA) – Physician Assistant, NPI 1619211463
Physician Assistant
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
5,036 PHYSICIAN ASSISTANT in OH
Provider Addresses for IRINA SERGEEVNA PETTY (PA)
2000 TAMARACK RD
NEWARK, OH 43055
Phone: (220) 564-4650
Fax: (220) 564-4238
Mailing address matches the actual address.
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: 2013-06-05
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20130605000644 | I | Physician Assistant | OH | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 215 | 158 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 145 | 107 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 32 | 32 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 16 | 16 | $0 |
Insurance plans in this area (ZIP 43055)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | OH | |
| Certified Registered Nurse Anesthetist (Crna) | OH | |
| - | OH | |
| Nurse Practitioner | OH | |
| U R O L O G Y | OH | |
| - | OH | |
| O B S T E T R I C S/ G Y N E C O L O G Y | OH | |
| Emergency Medicine | OH | |
| Certified Nurse Midwife (Cnm) | OH | |
| Pain Management | OH |
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