Irina Sergeevna Petty, PA - Medicare Physician Assistant in Newark, OH

Irina Sergeevna Petty, PA is a medicare enrolled "Physician Assistant" in Newark, Ohio. She graduated from nursing school in 2012 and has 12 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Licking Memorial Professional Corporation and her current practice location is 2000 Tamarack Rd, Newark, Ohio. You can reach out to her office (for appointments etc.) via phone at (220) 564-4650.

Irina Sergeevna Petty is licensed to practice in Ohio (license number 003613) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1619211463.

Contact Information

Irina Sergeevna Petty, PA
2000 Tamarack Rd,
Newark, OH 43055
(220) 564-4650
(220) 564-4238



Provider's Profile

Full NameIrina Sergeevna Petty
GenderFemale
SpecialityPhysician Assistant
Experience12 Years
Location2000 Tamarack Rd, Newark, Ohio
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Irina Sergeevna Petty graduated from nursing school in 2012
  NPI Data:
  • NPI Number: 1619211463
  • Provider Enumeration Date: 11/17/2012
  • Last Update Date: 04/02/2021
  Medicare PECOS Information:
  • PECOS PAC ID: 4284872094
  • Enrollment ID: I20130605000644

Medical Identifiers

Medical identifiers for Irina Sergeevna Petty such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1619211463NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363A00000XPhysician Assistant 003613 (Ohio)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Licking Memorial HospitalNewark, OHHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Licking Memorial Professional Corporation6204740731200

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Irina Sergeevna Petty is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Irina Sergeevna Petty, PA
2000 Tamarack Rd,
Newark, OH 43055

Ph: (220) 564-4650
Irina Sergeevna Petty, PA
2000 Tamarack Rd,
Newark, OH 43055

Ph: (220) 564-4650

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Physician Assistant Nurses in Newark, OH

Meghan Janet Meerschaert, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 1320 W Main St, Newark, OH 43055
Phone: 220-564-4151    Fax: 220-564-7153
Mrs. Jody Lee Wall, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 1320 W Main St, Newark, OH 43055
Phone: 220-564-4151    
Mr. Medhanie Kifle Kifle, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 1320 W Main St, Newark, OH 43055
Phone: 740-348-4137    Fax: 740-348-4119
Allan Ray Thomas, P.A.
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 1320 W Main St, Newark, OH 43055
Phone: 220-564-4151    Fax: 220-564-7153
Mrs. Tiffani Lynette Dorn, PA-C
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 919 Glyn Evans Ct, Newark, OH 43055
Phone: 740-405-5120    Fax: 740-788-8268
Cameron Evans, P.A.-C.
Physician Assistant
Medicare: Accepting Medicare Assignments
Practice Location: 1320 W Main St, Newark, OH 43055
Phone: 220-564-4151    Fax: 220-564-7175

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