Individual provider Active NPI

Brittney Marie Petersen, PA-C

  • Physician Assistant
  • Mesa, AZ
National Provider Identifier
1679160436
Registry record updated Aug 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
9614 Issued in AZ
Practice address
1500 S Dobson Rd Ste 202
Mesa, AZ 85202-4724
Phone
(866) 974-2673
Fax
(866) 939-2673
NPI assigned
Dec 28, 2020
Last updated
Aug 8, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 9614 AZ Primary
Physician Assistant 363A00000X NU
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

1500 S Dobson Rd Ste 202
Mesa, AZ 85202-4724

Mailing address

18444 N 25TH Ave Ste 310
Phoenix, AZ 85023-1266
Phone (866) 974-2673

Other practice location 1

3591 S Mercy Rd Ste 204
Gilbert, AZ 85297-2240
Phone (866) 974-2673

Other identifiers 1

IdentifierTypeStateIssuer
130515MedicaidAZ

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20230321000361 AZ Practitioner - Physician Assistant 2163896861 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10494 W Thunderbird Blvd
Sun City, AZ 85351-6122
Phone (866) 974-2673

13041 N del Webb Blvd
Suite 200
Sun City, AZ 85351-3034
Phone (623) 832-0300

14520 W Granite Valley Dr
Sun City West, AZ 85375-5855

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.65 of 100Reported as group
Quality
76.23
Promoting interoperability
100
Improvement activities
40
Cost
75.95

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9614AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Orthopedic Research and Educatoin CurrentSince Apr 15, 2023 Accepting new patients
Banner Cancer Center Specialists LLC CurrentSince Mar 1, 2026 Accepting new patients
Banner Cancer Center Specialists LLC CurrentSince Mar 1, 2026 Accepting new patients
Center for Orthopedic Research and Education, LLC Physician Assistant Past Accepting new patients

Locations

1900 N Higley Rd
Gilbert, AZ 85234
Phone (480) 543-2000

2946 E Banner Gateway Dr
Gilbert, AZ 85234
Phone (480) 256-5450

2946 E Banner Gateway Dr
Rm 2008
Gilbert, AZ 85234
Phone (480) 256-4523

3591 S Mercy Rd
Ste 204
Gilbert, AZ 85297
Phone (869) 742-6736

1500 S Dobson Rd
Ste 202
Mesa, AZ 85202
Phone (866) 974-2373

18444 N 25th Ave
Ste 310
Phoenix, AZ 85023
Phone (623) 241-8706

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

10494 W Thunderbird Blvd
Ste 102
Sun City, AZ 85351
Phone (623) 975-8311

13041 N Del Webb Blvd
Ste 200
Sun City, AZ 85351
Phone (623) 832-0300

14416 W Meeker Blvd
Ste 301
Sun City West, AZ 85375
Phone (623) 876-3800

14502 W Meeker Blvd
Sun City West, AZ 85375
Phone (623) 214-4000

Interoperability endpoints

  • Direct secure messaging: brittney.petersen.1@22724.direct.athenahealth.com

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1609113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1679160436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18444 N 25TH AVE STE 310",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850231266",
            "telephone_number": "866-974-2673",
            "fax_number": "866-939-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 S DOBSON RD STE 202",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852024724",
            "telephone_number": "866-974-2673",
            "fax_number": "866-939-2673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3591 S Mercy Rd Ste 204",
            "address_purpose": "LOCATION",
            "city": "Gilbert",
            "state": "AZ",
            "postal_code": "852972240",
            "country_code": "US",
            "telephone_number": "866-974-2673",
            "fax_number": "866-939-2673",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETERSEN",
        "first_name": "BRITTNEY",
        "middle_name": "MARIE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-12-28",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "9614",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "130515",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

Verify at the official NPI Registry.