Andrea Petersen, MSW

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

103 Caroline CT
Beaver Dam, WI 53916-1833

Phone

(608) 577-3879

NPI assigned

Jun 2, 2016

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Alarus Healthcare, LLC

  • Multi-Specialty Clinic/Center
  • Grafton, WI
  • NPI 1457788242
  Medicare reassignment NPD
• Alarus Home Health LLC

  • In Home Supportive Care Agency
  • Grafton, WI
  • NPI 1164834974
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1464825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464825600000",
    "number": "1093163743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 CAROLINE CT",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539161833",
            "telephone_number": "608-577-3879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 CAROLINE CT",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539161833",
            "telephone_number": "608-577-3879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "ANDREA",
        "credential": "MSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-02",
        "last_updated": "2016-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail L Paspalofski, DPT
• Tara Passow, M. D.
• William Perego
• Bethany N Perry, APNP
• Jayson Persch, PHARMD
• Elizabeth Michael Peterson, M.D.
• Emily Peterson, MD
• Eugene P Philipp Jr., PSYD
• Mary C Phung, CRNA
• Physical Therapy Solutions, Inc.

• Social Worker in Beaver Dam, WI
• Providers in Beaver Dam, WI by specialty
• Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.