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ANDREA R PETERSEN RD
NPI 1669661559
Dietitian, Registered in Osceola, WI

Active since October 17, 2007
2600 65TH AVENUE, OSCEOLA, WI 54020(715) 294-2111(715) 294-5758 Get Directions Write a Review

NPPES record last updated: October 21, 2010. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Andrea R Petersen Rd NPPES

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

ANDREA R PETERSEN RD (NPI 1669661559) is an individual dietitian, registered in Osceola, Wisconsin, licensed in Wisconsin (40815) and active in the NPI registry since October 2007.

NPPES Registry Identity

NPI1669661559
Entity TypeIndividualFemale
Primary Taxonomy133V00000X
Provider Legal NameANDREA R PETERSENCredential: RD
Location Address2600 65TH AVENUEOsceola, WI 54020-3024
Mailing AddressPo Box 218, 2600 65th AvenueOsceola, WI 54020-3024 · (715) 294-2111 · Fax (715) 294-2111
Phone(715) 294-2111
Fax(715) 294-5758
Sole ProprietorNo
Enumeration DateOctober 17, 2007
Last NPPES UpdateOctober 21, 2010
✔ NPI 1669661559 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDietitian, RegisteredDietary & Nutritional Service Providers
Taxonomy Code133V00000X
Licenses✔ Licensed in WI · 40815✔ Licensed in WI · 898228
Definition
A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation.
2600 65TH AVENUE, Osceola, WI 54020
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Other Identifiers 1

Other898228WI · Certificate

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Andrea R Petersen Rd is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

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

St. Croix Regional Medical Center
7.8 mi
Critical Access
235 STATE ST
Saint Croix Falls, WI 54024
  • Reassigned Medicare billing, Wisconsin enrollment
  • 453 clinicians in this Medicare group
NPI 1043240922 (715) 483-3221

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

NICOLE D SVIHEL PA-C
Physician Assistant (Medical)
2600 65TH AVENUE
OSCEOLA, WI 54020
Polk County (715) 294-2111
WARREN F ABELL JR. DO
Surgery
2600 65TH AVENUE
OSCEOLA, WI 54020
Polk County (715) 294-2111
LADD MEMORIAL HOSPITAL
Pharmacy (Community/Retail Pharmacy)
2600 65TH AVENUE
OSCEOLA, WI 54020
Polk County (715) 294-4050
JOAN M FLANDERS PT
Physical Therapist
2600 65TH AVENUE
OSCEOLA, WI 54020
Polk County (715) 294-2111
MRS. ANN M OLSON PT
Physical Therapist (Orthopedic)
2600 65TH AVENUE
OSCEOLA, WI 54020
Polk County (715) 294-2111
MRS. LANETTE M JOHNSON OTR
Occupational Therapist
2600 65TH AVENUE
OSCEOLA, WI 54020
Polk County (715) 294-2111
MRS. KELLY L HOGEN PTA
Physical Therapy Assistant
2600 65TH AVENUE
OSCEOLA, WI 54020
Polk County (715) 294-2111
MELINDA R GRANDAW OTR/L
Occupational Therapist
2600 65TH AVENUE
OSCEOLA, WI 54020
Polk County (715) 294-2111

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 Andrea Petersen's NPI number?

The NPI number for Andrea Petersen is 1669661559. It was assigned to this individual provider in the NPPES registry on October 17, 2007.

Where is Andrea Petersen located?

Andrea Petersen practices at 2600 65th Avenue, Osceola, WI 54020. The listed phone number is (715) 294-2111.

What is Andrea Petersen's specialty?

The primary specialty registered for this NPI is Dietitian, Registered with taxonomy code 133V00000X.

Is Andrea Petersen enrolled in Medicare?

Yes. Andrea Petersen is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Andrea Petersen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Andrea Petersen reassigns Medicare benefits to St. Croix Regional Medical Center (Saint Croix Falls, WI). 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 Andrea Petersen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Andrea Petersen accept?

Health plans from Medica list Andrea Petersen as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Andrea Petersen was last updated on October 21, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.