PETRA ELIZABETH JANS PEDERSON MD, PHD
NPI 1285377697
Internal Medicine in La Jolla, CA

Q: What is Petra Pederson's NPI number?

The NPI number for Petra Pederson is 1285377697. It was assigned to this individual provider in the NPPES registry on April 14, 2022.

Q: What is Petra Pederson's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Petra Pederson was last updated on June 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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 April 14, 2022PECOS EnrolledAccepts Medicare Assignment

10710 N TORREY PINES RD, LA JOLLA, CA 92037(858) 554-7272 Get Directions Write a Review

NPPES record last updated: June 23, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jun 23, 2025, Apr 14, 2022 (2 updates tracked since 2022).

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About Petra Elizabeth Jans Pederson Md, Phd NPPES

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

PETRA ELIZABETH JANS PEDERSON MD, PHD (NPI 1285377697) is an individual internal medicine provider in La Jolla, California, licensed in California (A191033) and active in the NPI registry since April 2022. She is enrolled in Medicare PECOS, maintains a secondary practice location in La Jolla, and is a graduate of Other (2022).

NPPES Registry Identity

NPI1285377697

Entity TypeIndividualFemale

Primary Taxonomy207R00000X

Provider Legal NamePETRA ELIZABETH JANS PEDERSONCredential: MD, PHD

Location Address10710 N TORREY PINES RDLa Jolla, CA 92037-1035

Mailing Address10790 Rancho Bernardo RdSan Diego, CA 92127-5705 · (858) 554-7272

Phone(858) 554-7272

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateApril 14, 2022

Last NPPES UpdateJune 23, 20252 updates tracked since enumeration

NPPES CertifiedJune 23, 2025

✔ NPI 1285377697 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in CA · A191033

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

10710 N TORREY PINES RD, La Jolla, CA 92037

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Secondary Practice Location 1

Location 110666 N Torrey Pines RdLA Jolla, CA 92037-1027 · Phone (858) 554-3200

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

Petra Elizabeth Jans Pederson Md, Phd 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 ID749794477

PECOS Enrollment IDI20250707001309

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.

Medicare Billing Reassignment

Medicare enrollment records show Petra Pederson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Scripps Health

0.2 mi

Multi-Specialty

10666 N TORREY PINES RD
La Jolla, CA 92037

Reassigned Medicare billing, California enrollment
1,598 clinicians in this Medicare group

NPI 1275899072 (858) 554-9100

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 92037 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.

MS. JUMAI FATHIYA DAWUDA NP

Nurse Practitioner (Family)