Andrew Thomas Petrak, DNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

259011 Issued in AZ

Practice address

1323 W Prince Rd
Tucson, AZ 85705-3114

Phone

(520) 887-0800

Fax

(520) 887-1393

NPI assigned

Jul 2, 2021

Last updated

Jan 29, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Marana Health Center IncGroup PAC ID 2365348091, shared by 14 NPIs, 114 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: andrew.petrak.1@32652.direct.athenahealth.com
• Direct secure messaging: andrew.petrak@1278.direct.myezyaccess.com
• Direct secure messaging: apetrak21884@elrio.direct.ci.com

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

• Marana Health Center Inc

  dba MHC Healthcare Dental Office

  • Federally Qualified Health Center (FQHC)
  • Tucson, AZ
  • NPI 1396512034
  NPD
• Marana Health Center, Inc

  dba MHC Healthcare

  • Federally Qualified Health Center (FQHC)
  • Marana, AZ
  • NPI 1447263405

  Family

  NPD
• Marana Health Center, Inc

  dba MHC Integrated Care Pharmacy

  • Clinic Pharmacy
  • Tucson, AZ
  • NPI 1073072450
  NPD (past)
• Marana Health Center, Inc

  dba Wilmot Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Tucson, AZ
  • NPI 1295986735
  NPD (past)

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

{
    "created_epoch": "1625184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1144891037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "MARANA",
            "state": "AZ",
            "postal_code": "856530188",
            "telephone_number": "520-887-0800",
            "fax_number": "520-887-1393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1323 W PRINCE RD",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857053114",
            "telephone_number": "520-887-0800",
            "fax_number": "520-887-1393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRAK",
        "first_name": "ANDREW",
        "middle_name": "THOMAS",
        "credential": "DNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-02",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AZ",
            "license": "259011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "096533",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shannon Lynn Peterson, RN
• Sharon Peterson, OD
• Shaun N Peterson, MD
• Spencer O'Brien Peterson, D.O.
• Rachelle Rae Petika, NP-C
• Jason Thomas Petras, MA, BCBA
• Lane Louise Petri, A/GNP
• Joseph Michael Petrick Jr., RPH
• Marden Petrie, PSY.D.
• Christina Carol Petrin

• Family Nurse Practitioner in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Family Nurse Practitioner in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.