DR. ANDREW BURTON DICKERSON
NPI 1063916633
Pediatrics - Pediatric Gastroenterology in San Diego, CA
About Dr. Andrew Burton Dickerson NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. ANDREW BURTON DICKERSON (NPI 1063916633) is an individual pediatric gastroenterology provider in San Diego, California, licensed in California (A164904) and active in the NPI registry since March 2018. He is enrolled in Medicare PECOS and is a graduate of University Of Tennessee, Hsc, College Of Medicine (2014).
NPPES Registry Identity
Specialties & Licenses 2
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Andrew Burton Dickerson 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.
Medicare Billing Reassignment
Medicare enrollment records show Andrew Dickerson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
San Diego, CA 92123
- Reassigned Medicare billing, California enrollment
- 562 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 92123 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
SAN DIEGO, CA 92123
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Andrew Dickerson's NPI number?
The NPI number for Andrew Dickerson is 1063916633. It was assigned to this individual provider in the NPPES registry on March 20, 2018.
Where is Andrew Dickerson located?
Andrew Dickerson practices at 3030 Childrens Way, San Diego, CA 92123. The listed phone number is (858) 966-4003.
What is Andrew Dickerson's specialty?
The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Gastroenterology, with taxonomy code 2080P0206X.
Is Andrew Dickerson enrolled in Medicare?
Yes. Andrew Dickerson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Andrew Dickerson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Andrew Dickerson reassigns Medicare benefits to Rady Children's Hospital San Diego (San Diego, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Andrew Dickerson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Andrew Dickerson was last updated on April 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.
# Dr. Andrew Burton Dickerson · NPI 1063916633
Pediatric Gastroenterology physician in San Diego, California. Individual provider, active in the CMS NPPES registry since March 20, 2018.
## Identity
- **NPI:** 1063916633 (Entity type: Individual)
- **Enumerated:** March 20, 2018
- **Primary specialty:** Pediatrics - Pediatric Gastroenterology · taxonomy 2080P0206X
- **State license:** A164904 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 3030 CHILDRENS WAY, San Diego, CA 92123-4232
- **Phone:** (858) 966-4003
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Rady Children's Hospital San Diego (NPI 1669617197, San Diego, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Tennessee, Hsc, College Of Medicine, class of 2014
## Record status
- **NPPES last updated:** April 25, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1063916633) · Data from the CMS NPPES public registry.