Look up the most recent NPI and PECOS records

Jaclyn Petrichevich

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

300 Halket St Ste 1731, Pittsburgh, PA 15213-3108

PECOS Enrollment

Based on the most recent information from CMS, provider Jaclyn Petrichevich is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1174373336
Provider Type
Individual
Full Name
Petrichevich, Jaclyn
Credential
PA-C

Gender
Female
Sole Proprietor
No
Enumeration Date
3/22/2024
Last Updated
3/22/2024

Contact Information

Practice Location

300 Halket St Ste 1731, Pittsburgh, PA 15213-3108

(412) 641-1000

Unlisted Fax

Mailing Location

146 Twilight Dr, Canonsburg, PA 15317-0505

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363AM0700X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License MA065457 Pennsylvania

Jaclyn Petrichevich

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Guerrero, Brenda

Herrem, Michelle Lynn

Heinzmann, Mekayla Ann

Carroll, Lauren Michelle

Depierre, Sara E

Steele, Sara

Shaffer, Edward

Petrucci, Julia

O'Neil, Caroline Anne

Hennicke, Chrisanne