ANDREA RAE PETERSEN MPH, PA-C
NPI 1063854669
Physician Assistant in Newport Beach, CA

Q: What is Andrea Petersen's NPI number?

The NPI number for Andrea Petersen is 1063854669. It was assigned to this individual provider in the NPPES registry on July 24, 2013.

Q: What is Andrea Petersen's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Andrea Petersen was last updated on November 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 24, 2013PECOS EnrolledAccepts Medicare Assignment

84.34/100

CMS Quality Rating

500 SUPERIOR AVE STE 310, NEWPORT BEACH, CA 92663(949) 644-2722(949) 650-3135 Get Directions Write a Review

NPPES record last updated: November 3, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 3, 2025, Nov 11, 2024 (2 updates tracked since 2024).

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About Andrea Rae Petersen Mph, Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANDREA RAE PETERSEN MPH, PA-C (NPI 1063854669) is an individual physician assistant in Newport Beach, California, licensed in California (65363) and active in the NPI registry since July 2013. She is enrolled in Medicare PECOS and is a graduate of Other (2013).

NPPES Registry Identity

NPI1063854669

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameANDREA RAE PETERSENCredential: MPH, PA-C

Location Address500 SUPERIOR AVE STE 310Newport Beach, CA 92663-3609

Mailing Address500 Superior Ave Ste 310Newport Beach, CA 92663-3609 · (949) 644-2722 · Fax (949) 650-3135

Phone(949) 644-2722

Fax(949) 650-3135

Sole ProprietorNo

Medical School CMSOtherGraduated 2013

Enumeration DateJuly 24, 2013

Last NPPES UpdateNovember 3, 20252 updates tracked since enumeration

NPPES CertifiedNovember 3, 2025

✔ NPI 1063854669 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Licenses✔ Licensed in CA · 65363✔ Licensed in MN · 11722

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

500 SUPERIOR AVE STE 310, Newport Beach, CA 92663

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners, Medica.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Andrea Rae Petersen Mph, Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6305169871

PECOS Enrollment IDI20241112001229

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92663 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$77.96 typical visit price

range $20.84 – $153.61

Typical copayment $19.49 (range $5.21 – $38.40)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

84.34/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored as part of a group practice

Quality

86.33

Promoting Interoperability

100

Improvement Activities

Cost

61.49

Reported Quality Measures

Breast Cancer Screening

62%92 patients3/55-star benchmark: 93%

Cervical Cancer Screening

80%769 patients4/55-star benchmark: 98%

Closing the Referral Loop: Receipt of Specialist Report

16%92 patients1/55-star benchmark: 87%

Documentation of Current Medications in the Medical Record

94%1,340 patients4/55-star benchmark: 100%

e-Prescribing

100%485 patients5/55-star benchmark: 100%

Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan

36%579 patients2/55-star benchmark: 98%

Preventive Care and Screening: Screening for High Blood Pressure and Follow-Up Documented

44%1,255 patients3/55-star benchmark: 61%

Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention

Patients screened: 39% · 699 patients

38%699 patients

Provide Patients Electronic Access to Their Health Information

98%366 patients4/55-star benchmark: 100%

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SANDRA MARISSA TOLEDO FNP-C

Nurse Practitioner