Meagan Petrek, A.P.R.N.

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95005125 Issued in CA

Practice address

3900 Fifth Ave Ste 110
San Diego, CA 92103-3122

Phone

(858) 554-1212

Fax

(858) 430-3146

NPI assigned

Jun 19, 2015

Last updated

Feb 10, 2022By the provider in NPPES

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

Other names 1

• Meagan Goodman Former name

Medicare fee-for-service enrollment

Enrolled in NE, CA, TX3 enrollments

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 3

Specialty

Nurse Practitioner

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Value Based Long Term Care B PCGroup PAC ID 4082017884, 28 clinicians

Nebraska House Call Physicians PCGroup PAC ID 7517911555, 23 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

92.17 of 100Reported as group

Quality

100

Promoting interoperability

100

Improvement activities

40

Cost

73.9

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Nebraska House Call Physicians, P.C.

  • Internal Medicine Physician
  • Lincoln, NE
  • NPI 1811931637
  Medicare reassignment Care Compare group NPD
• Value Based Long Term Care B PC

  • Internal Medicine Physician
  • Lincoln, NE
  • NPI 1194498808
  Medicare reassignment Care Compare group NPD
• Monica Perlman MD Inc.

  dba Perlman Clinic

  • Primary Care Clinic/Center
  • La Jolla, CA
  • NPI 1134309305
  Medicare reassignment NPD
• Advanced Medical Imaging, LLC

  • Diagnostic Radiology Physician
  • Lincoln, NE
  • NPI 1437116936
  Medicare reassignment NPD
• Cerebral Medical Group, a Professional Corporation

  • Psychiatry Physician
  • Glendale, CA
  • NPI 1992355879

  TX

  Medicare reassignment
• Lightbridge Hospice, LLC

  dba Lightbridge Hospice

  • Community Based Hospice Care Agency
  • San Diego, CA
  • NPI 1154320299
  NPD (past)
• Regents of the University of California

  dba Ucsd Medical Center Pharmacy

  • Pharmacy
  • San Diego, CA
  • NPI 1598786576
  NPD (past)
• UC San Diego Health - Rancho Family Medical Group

  • Multi-Specialty Clinic/Center
  • Temecula, CA
  • NPI 1003385071
  NPD (past)

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

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644451200000",
    "number": "1376925974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 S DITMAR ST",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920546526",
            "telephone_number": "402-613-3916",
            "fax_number": "858-430-3146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 FIFTH AVE STE 110",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921033122",
            "telephone_number": "858-554-1212",
            "fax_number": "858-430-3146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETREK",
        "first_name": "MEAGAN",
        "credential": "A.P.R.N.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-06-19",
        "last_updated": "2022-02-10",
        "certification_date": "2022-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95005125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEAGAN",
            "last_name": "GOODMAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Anneliese Petitt
• Angela Petkofsky
• Patrick Petprasert
• Brent A Petre, DPT
• Yasmin Petree, PSYD.
• Josephine Finneran Petrich
• Charles R. Petrie I, D.D.S.
• Kristen M Petrie
• Michelle Marie Petrie, M.D.
• Rachel Cyan Petrie

• Nurse Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2022; 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.