Timothy S Pedersen, MS, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

8305 Issued in MA

Practice address

17 Sarahs Way
Fairhaven, MA 02719-3161

Phone

(508) 991-2918

Fax

(508) 994-3068

NPI assigned

Nov 1, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Synergy Healthcare CorpGroup PAC ID 1658535141, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Locations

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.

• Synergy Healthcare Corp

  • Physical Therapy Clinic/Center
  • Fairhaven, MA
  • NPI 1205101193

  Physical Therapist

  Medicare reassignment Care Compare group NPD Authorized official
• Synergy Healthcare Corporation

  • Physical Therapist
  • Fairhaven, MA
  • NPI 1669743019
  NPD Authorized official

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315440000000",
    "number": "1114004231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 SARAHS WAY",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027193161",
            "telephone_number": "508-991-2918",
            "fax_number": "508-994-3068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 SARAHS WAY",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027193161",
            "telephone_number": "508-991-2918",
            "fax_number": "508-994-3068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "TIMOTHY",
        "middle_name": "S",
        "name_prefix": "Mr.",
        "credential": "MS, PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2011-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "8305",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "RI",
            "license": "PT01872",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110088219A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian Palmer
• Tina M Parker-Howayeck, O.D.
• Sagar Sudhirchandra Patel, MD
• Nirmal Pathak, M.D.
• Peace of Mind Wellness, Inc.
• Jean Claude Petit Me, D.O
• Pharmahealth Longterm Care Inc
• Pharmahealth Specialty/Long Term Care, Inc.
• Edward Francis Philbin, M.D.
• Phonedoctorx, LLC.

• Physical Therapist in Fairhaven, MA
• Providers in Fairhaven, MA by specialty
• Physical Therapist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.