This study assessed factors impacting practice selection among primary care and specialty physician assistants (PAs). Certified PAs randomized by the National Commission on Certification of Physician Assistants (NCCPA) (30,000) were surveyed, with 2,020 responses (RR = 6.7%). Results showed that factors influencing primary care and specialty selection differ. Increasing reimbursements may not increase selection of primary care by PAs.