Barry D. M. Pederson, OTR

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

3123 Issued in CO

Practice address

601 Griffin PL
Apt a
Fort Collins, CO 80521-1896

Phone

(303) 579-0322

NPI assigned

Jan 12, 2012

Last updated

May 7, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Enrolled in OR

Enrollment records 1

Specialty

Occupational Therapist in Private Practice

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Providence Health and Services OregonGroup PAC ID 0648183608, 1,423 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Providence Health & Services Oregon

  dba Providence Medical Group

  • General Practice Physician
  • Lake Oswego, OR
  • NPI 1023488343
  Medicare reassignment Care Compare group NPD
• Evergreen Therapy LLC

  • Occupational Therapist
  • Fort Collins, CO
  • NPI 1881039451
  NPD (past) Authorized official
• Providence Health & Services - Oregon

  dba Providence Medical Group

  • Pediatrics Physician
  • Bend, OR
  • NPI 1194996991
  NPD
• Providence Health & Services Oregon

  dba Providence Medical Group

  • Psychiatry Physician
  • Portland, OR
  • NPI 1760177737
  NPD
• Providence Health & Services - Oregon

  dba Providence Medical Group

  • Internal Medicine Physician
  • Sherwood, OR
  • NPI 1184729329
  NPD (past)

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

{
    "created_epoch": "1326326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367884800000",
    "number": "1215208855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 GRIFFIN PL",
            "address_2": "APT A",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805211896",
            "telephone_number": "303-579-0322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 GRIFFIN PL",
            "address_2": "APT A",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805211896",
            "telephone_number": "303-579-0322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSON",
        "first_name": "BARRY",
        "middle_name": "D. M.",
        "name_prefix": "Mr.",
        "credential": "OTR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-01-12",
        "last_updated": "2013-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CO",
            "license": "3123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tyler Pecha, DPT
• Steven Harry Peck, MD
• Aspin Pecor
• Macy Pedersen
• Sonya Magdelano Pedersen, F.N.P.
• Pediatric Associates of Fort Collins, PLLC
• Pediatric Associates of Northern Colorado
• Pediatric Dentistry of the Rockies PLLC (Pediatric Dentistry of the Rockies)
• Pediatric Occupational Therapy Services, LLC (Little Bugs Gym)
• Andrea G Giselle Pedroza

• Occupational Therapist in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Occupational Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2013; 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.