ANDREW JOHN PETKUS PH.D.
NPI 1184152241
Psychologist - Clinical in Los Angeles, CA
About Andrew John Petkus Ph.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ANDREW JOHN PETKUS PH.D. (NPI 1184152241) is an individual clinical provider in Los Angeles, California, licensed in California (PSY-28858) and active in the NPI registry since June 2017. He is enrolled in Medicare PECOS and is a graduate of Other (2014).
NPPES Registry Identity
Specialties & Licenses
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
Andrew John Petkus Ph.d. 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 Petkus reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Los Angeles, CA 90033
- Reassigned Medicare billing, California enrollment
- 2,445 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.
Areas of Expertise CMS Part B claims 4
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 90033 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.
LOS ANGELES, CA 90033
LOS ANGELES, CA 90033
LOS ANGELES, CA 90033
LOS ANGELES, CA 90033
LOS ANGELES, CA 90033
LOS ANGELES, CA 90033
LOS ANGELES, CA 90033
LOS ANGELES, CA 90033
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 Petkus's NPI number?
The NPI number for Andrew Petkus is 1184152241. It was assigned to this individual provider in the NPPES registry on June 1, 2017.
Where is Andrew Petkus located?
Andrew Petkus practices at 1520 San Pablo St Ste 3000, Los Angeles, CA 90033. The listed phone number is (323) 442-5710.
What is Andrew Petkus's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.
Is Andrew Petkus enrolled in Medicare?
Yes. Andrew Petkus 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 Petkus's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Andrew Petkus reassigns Medicare benefits to Usc Care Medical Group, Inc (Los Angeles, 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 Petkus'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 Petkus was last updated on November 27, 2023. 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.
# Andrew John Petkus, PH.D. · NPI 1184152241
Clinical provider in Los Angeles, California. Individual provider, active in the CMS NPPES registry since June 1, 2017.
## Identity
- **NPI:** 1184152241 (Entity type: Individual)
- **Enumerated:** June 1, 2017
- **Primary specialty:** Psychologist - Clinical · taxonomy 103TC0700X
- **State license:** PSY-28858 (California)
- **Sole proprietor:** No
## Practice location
- **Address:** 1520 SAN PABLO ST STE 3000, Los Angeles, CA 90033-5315
- **Phone:** (323) 442-5710
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Usc Care Medical Group, Inc (NPI 1902846306, Los Angeles, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2014
## Record status
- **NPPES last updated:** November 27, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1184152241) · Data from the CMS NPPES public registry.