Craig J Pedersen, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA-303 Issued in ME

Practice address

489 State St
Bangor, ME 04401-6616

Phone

(207) 973-7000

Fax

(207) 973-5042

NPI assigned

May 18, 2006

Last updated

Dec 2, 2010By 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• John a. Bradford M.D., P.a.

  • Specialist
  • Bangor, ME
  • NPI 1255667226
  NPD (past)
• MRH Corp.

  dba Northern Light Primary Care Dover-Foxcroft

  • Family Medicine Physician
  • Dover Foxcroft, ME
  • NPI 1548382328
  NPD (past)
• Northeast Cardiology Associates

  • Cardiovascular Disease Physician
  • Bangor, ME
  • NPI 1417908302
  NPD (past)
• Norumbega Medical Specialists, LTD

  • Health Service Clinic/Center
  • Brewer, ME
  • NPI 1780821140
  NPD (past)

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291248000000",
    "number": "1073566329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43 WHITING HILL RD STE 300",
            "city": "BREWER",
            "state": "ME",
            "postal_code": "044121006",
            "telephone_number": "207-973-5035",
            "fax_number": "207-973-5042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 STATE ST",
            "city": "BANGOR",
            "state": "ME",
            "postal_code": "044016616",
            "telephone_number": "207-973-7000",
            "fax_number": "207-973-5042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "CRAIG",
        "middle_name": "J",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2010-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "ME",
            "license": "PA-303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• PCHC Physical Therapy and Balance Center
• Grace Pearson, PA-C
• Carlarae Jean Peavey-Mitchell, PMH-NP
• Carol Ann Peavey, FNP
• Robert Stephen Peddicord, PH.D.
• Jared Peet, CADC
• Elizabeth R Pelissier, APRN
• David E Pelkey, LADC
• Lisa V Pelkey, FNP
• Nicholas Jon Pelkey, LADC

• Medical Physician Assistant in Bangor, ME
• Providers in Bangor, ME by specialty
• Medical Physician Assistant in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.