Alexandra Dee Petersen

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

13555 Bowman Rd
Auburn, CA 95603-3156

Phone

(530) 885-3951

NPI assigned

Dec 16, 2019

Sex

Female

Sole proprietor

No

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 CA

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

Physician Assistant

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Medicine Physician Partners of El Dorado County IncGroup PAC ID 1456530153, 6 clinicians

Dispatchhealth-Ca PCGroup PAC ID 4789086455, 29 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marshall Medical Center Hospital, Placerville, CA, CCN 050254

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Interoperability endpoints

• Direct secure messaging: alexandra.petersen.1@13869.direct.athenahealth.com

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.

• Dispatchhealth-Ca, PC

  • Emergency Medicine Physician
  • Tustin, CA
  • NPI 1639752553
  Medicare reassignment Care Compare group
• Emergency Medicine Physician Partners of El Dorado County, Inc

  • Emergency Medicine Physician
  • Placerville, CA
  • NPI 1619278660
  Medicare reassignment Care Compare group
• Vista Complete Care, Inc.

  • Family Medicine Physician
  • Auburn, CA
  • NPI 1851603278
  Medicare reassignment
• Professional Portable Radiologic Services Inc.

  • Physiological Laboratory
  • Houston, TX
  • NPI 1457087991
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Marshall Medical Center

  • General Acute Care Hospital
  • Placerville, CA
  • NPI 1972503142
  Care Compare affiliation

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

{
    "created_epoch": "1576454400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1225676778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13555 BOWMAN RD",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956033156",
            "telephone_number": "530-885-3951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13555 BOWMAN RD",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956033156",
            "telephone_number": "530-885-3951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "ALEXANDRA",
        "middle_name": "DEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-16",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Lynne Perry, DC
• Pes-Ebs.Inc.
• Pes-Ebs.Inc.
• Steven Pesanka, LCSW
• James J Peters, PT
• Carolyn Ann Peterson, PH.D.
• Michelle Peterson
• Sharnay Michelle Peterson
• Sherri L Peterson, PT
• Tamatha Shon Peterson

• Physician Assistant in Auburn, CA
• Providers in Auburn, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; 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.