Heather M. Pederson, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PS017887 Issued in PA

Practice address

1880 John F Kennedy Blvd FL18
Philadelphia, PA 19103

Phone

(215) 575-9140

NPI assigned

Sep 23, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 31, 2019 through May 31, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• Bethel Olentangy Psychological Services

  • Clinical Psychologist
  • Columbus, OH
  • NPI 1477003143
  NPD (past)
• M a Orcutt PHD & Associates

  • Clinical Psychologist
  • Columbus, OH
  • NPI 1194894766
  NPD (past)

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

{
    "created_epoch": "1253664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439856000000",
    "number": "1073847166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1880 JOHN F KENNEDY BLVD FL18",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19103",
            "telephone_number": "215-575-9140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1880 JOHN F KENNEDY BLVD FL18",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19103",
            "telephone_number": "215-575-9140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSON",
        "first_name": "HEATHER",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-23",
        "last_updated": "2015-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "OH",
            "license": "7057",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "PA",
            "license": "PS017887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea D Pedano, D.O.
• Vinay Pedapati
• Vijay Gopal Reddy Peddareddigari, MD
• Sreya Peddi
• Greg Pedegana, CRNA
• Courtney Day Pederzani, PSY.D.
• Lisa Pedevillano, DO
• Pediatric & Preventive Medicine Assoc PC
• Pediatric and Adolescent Medicine Group
• Pediatric Dental Assoc LTD

• Psychologist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2015; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.