DR. ANDREW BURTON DICKERSON
NPI 1063916633
Pediatrics - Pediatric Gastroenterology in San Diego, CA

Active since March 20, 2018PECOS EnrolledAccepts Medicare Assignment
3030 CHILDRENS WAY, SAN DIEGO, CA 92123(858) 966-4003 Get Directions Write a Review

NPPES record last updated: April 25, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 25, 2024, Feb 28, 2023, Mar 20, 2018 (3 updates tracked since 2018).

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

NPI1063916633
Entity TypeIndividualMale
Primary Taxonomy2080P0206X
Provider Legal NameDR. ANDREW BURTON DICKERSON
Location Address3030 CHILDRENS WAYSan Diego, CA 92123-4232
Mailing Address3020 Childrens Way # Mc5003San Diego, CA 92123-4223 · (858) 309-6300
Sole ProprietorNo
Medical School CMSUniversity Of Tennessee, Hsc, College Of MedicineGraduated 2014
Enumeration DateMarch 20, 2018
Last NPPES UpdateApril 25, 20243 updates tracked since enumeration
NPPES CertifiedApril 25, 2024
NPI 1063916633 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPediatrics · Pediatric GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0206X
License Licensed in CA · A164904
Definition
A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs.
Also ListedPediatricsTaxonomy 208000000X · License A164904 (CA)
3030 CHILDRENS WAY, San Diego, CA 92123

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

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.

PECOS PAC ID4284064908
PECOS Enrollment IDI20241111000604
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 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.

New Patient
$140.22 typical visit price
range $62.10 – $184.71
Typical copayment $35.05 (range $15.52 – $46.17)
Most-billed visit code 99204
Established Patient
$108.42 typical visit price
range $20.62 – $151.42
Typical copayment $27.10 (range $5.15 – $37.85)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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.

Allergy & Immunology
3030 CHILDRENS WAY
SAN DIEGO, CA 92123
Orthopaedic Surgery
3030 CHILDRENS WAY
SAN DIEGO, CA 92123
Orthopaedic Surgery
3030 CHILDRENS WAY, SUITE 410
SAN DIEGO, CA 92123
Ophthalmology
3030 CHILDRENS WAY, SUITE 109
SAN DIEGO, CA 92123
Pediatrics (Pediatric Gastroenterology)
3030 CHILDRENS WAY
SAN DIEGO, CA 92123
Pediatrics
3030 CHILDRENS WAY, SUITE 213
SAN DIEGO, CA 92123
Orthopaedic Surgery
3030 CHILDRENS WAY, SUITE 410
SAN DIEGO, CA 92123
Nurse Practitioner (Pediatrics)
3030 CHILDRENS WAY, STE 410
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.

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.