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ANDREW TENNANT PENNOCK M.D.
NPI 1619151685
Orthopaedic Surgery in San Diego, CA

Active since December 26, 2007PECOS Enrolled
3030 CHILDRENS WAY, STE 410, SAN DIEGO, CA 92123(858) 966-6789(858) 966-8519 Get Directions Write a Review

NPPES record last updated: November 2, 2011. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Andrew Tennant Pennock M.d. NPPES

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

ANDREW TENNANT PENNOCK M.D. (NPI 1619151685) is an individual orthopaedic surgery provider in San Diego, California, licensed in California (A90049) and active in the NPI registry since December 2007. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1619151685
Entity TypeIndividualMale
Primary Taxonomy207X00000X
Provider Legal NameANDREW TENNANT PENNOCKCredential: M.D.
Location Address3030 CHILDRENS WAY, STE 410San Diego, CA 92123-4232
Mailing Address3860 Calle Fortunada, Ste #210San Diego, CT 92123-4802 · (858) 309-6303 · Fax (858) 309-6301
Phone(858) 966-6789
Fax(858) 966-8519
Sole ProprietorNo
Enumeration DateDecember 26, 2007
Last NPPES UpdateNovember 2, 2011
✔ NPI 1619151685 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOrthopaedic SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code207X00000X
License✔ Licensed in CA · A90049
Definition
An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.
3030 CHILDRENS WAY, San Diego, CA 92123
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Andrew Tennant Pennock M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Andrew Pennock reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Rady Children's Hospital San Diego
0.1 mi
Pediatrics
3020 CHILDRENS WAY
San Diego, CA 92123
  • Reassigned Medicare billing, California enrollment
  • 562 clinicians in this Medicare group
NPI 1669617197 (858) 966-5911

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.

New Patient
$94.87 typical visit price
range $62.10 – $184.71
Typical copayment $23.71 (range $15.52 – $46.17)
Most-billed visit code 99203
Established Patient
$76.87 typical visit price
range $20.62 – $151.42
Typical copayment $19.21 (range $5.15 – $37.85)
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.

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.

DR. STEPHANIE LEONARD MEASURES MD
Allergy & Immunology
3030 CHILDRENS WAY
SAN DIEGO, CA 92123
San Diego County (858) 966-5961
DR. STEVEN ALEXANDER BUREKHOVICH MD
Orthopaedic Surgery
3030 CHILDRENS WAY
SAN DIEGO, CA 92123
San Diego County (858) 966-6789
ERIC WILLIAM EDMONDS MD
Orthopaedic Surgery
3030 CHILDRENS WAY, SUITE 410
SAN DIEGO, CA 92123
San Diego County (858) 966-6789
CHILDREN'S SPECIALISTS OF SAN DIEGO - DIV OF OPTH
Ophthalmology
3030 CHILDRENS WAY, SUITE 109
SAN DIEGO, CA 92123
San Diego County (858) 309-7701
ANGELA LEE CHU M.D.
Pediatrics (Pediatric Gastroenterology)
3030 CHILDRENS WAY
SAN DIEGO, CA 92123
San Diego County (858) 966-4003
HERBERT CLIFFORD KIMMONS JR. M.D.
Pediatrics
3030 CHILDRENS WAY, SUITE 213
SAN DIEGO, CA 92123
San Diego County (858) 966-8567
PETER OWEN NEWTON M.D.
Orthopaedic Surgery
3030 CHILDRENS WAY, SUITE 410
SAN DIEGO, CA 92123
San Diego County (858) 966-6789
MARYLOU SCOTT CPNP
Nurse Practitioner (Pediatrics)
3030 CHILDRENS WAY, STE 410
SAN DIEGO, CA 92123
San Diego County (858) 966-6789

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 Pennock's NPI number?

The NPI number for Andrew Pennock is 1619151685. It was assigned to this individual provider in the NPPES registry on December 26, 2007.

Where is Andrew Pennock located?

Andrew Pennock practices at 3030 Childrens Way Ste 410, San Diego, CA 92123. The listed phone number is (858) 966-6789.

What is Andrew Pennock's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery with taxonomy code 207X00000X.

Is Andrew Pennock enrolled in Medicare?

Yes. Andrew Pennock is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Andrew Pennock's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Andrew Pennock 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 Pennock'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 Pennock was last updated on November 2, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.