MR. ANDREW G PETLOCK PA
NPI 1972381077
Physician Assistant in Hudson, MA

Q: What is Andrew Petlock's NPI number?

The NPI number for Andrew Petlock is 1972381077. It was assigned to this individual provider in the NPPES registry on September 19, 2023.

Q: What is Andrew Petlock's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Q: When was this NPI record last updated?

The NPPES record for Andrew Petlock was last updated on October 1, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 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 September 19, 2023PECOS EnrolledAccepts Medicare Assignment

1 CABOT RD STE 101, HUDSON, MA 01749(978) 562-3536(978) 562-4626 Get Directions Write a Review

NPPES record last updated: October 1, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Mr. Andrew G Petlock Pa NPPES

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

MR. ANDREW G PETLOCK PA (NPI 1972381077) is an individual physician assistant in Hudson, Massachusetts and active in the NPI registry since September 2023. He is enrolled in Medicare PECOS, is affiliated with Umass Memorial Healthcare-marlborough Hospital, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1972381077

Entity TypeIndividualMale

Primary Taxonomy363A00000X

Provider Legal NameMR. ANDREW G PETLOCKCredential: PA

Location Address1 CABOT RD STE 101Hudson, MA 01749-2963

Mailing Address171 Main St Ste 203bAshland, MA 01721-1187 · (508) 881-3029 · Fax (508) 881-1752

Phone(978) 562-3536

Fax(978) 562-4626

Sole ProprietorYes

Medical School CMSOtherGraduated 2024

Enumeration DateSeptember 19, 2023

Last NPPES UpdateOctober 1, 2024

NPPES CertifiedOctober 1, 2024

✔ NPI 1972381077 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

1 CABOT RD STE 101, Hudson, MA 01749

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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

Mr. Andrew G Petlock Pa 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 ID3870025208

PECOS Enrollment IDI20241010001126

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.

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Umass Memorial Healthcare-Marlborough Hospital

Acute Care Hospitals · Marlborough, MA

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220049

Location157 Union StreetMarlborough, MA 01752 · Middlesex County

Emergency services

Winchester Hospital

Acute Care Hospitals · Winchester, MA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220105

Location41 Highland AvenueWinchester, MA 01890 · Middlesex County

Emergency services Birthing friendly

Umass Memorial Medical Center/University Campus

Acute Care Hospitals · Worcester, MA

4/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number220163

Location55 Lake Avenue NorthWorcester, MA 01655 · Worcester County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01749 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

$97.64 typical visit price

range $63.72 – $189.86

Typical copayment $24.41 (range $15.93 – $47.46)

Most-billed visit code 99203

Established Patient

$78.84 typical visit price

range $21.07 – $155.29

Typical copayment $19.71 (range $5.26 – $38.82)

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 6

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

BRETT EVERETT EKSTROM FNP-C

Nurse Practitioner (Primary Care)