Anders Bjorn Pederson, MD
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · La Crosse, WI
NPI 1386495745 · NPPES record last updated Apr 1, 2024
Key facts
- NPI
- 1386495745
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 1836 South Ave
La Crosse, WI 54601-5429 - Phone
- (608) 782-7300
- NPI assigned
- Apr 1, 2024
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240710004152 | WI | Order and Referring Only - General Surgery |
6103361464 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
1836 South Ave
La Crosse, WI 54601-5429
Mailing address
1836 South Ave
La Crosse, WI 54601-5429
Phone (608) 782-7300
Other providers in La Crosse, WI
- Marcus Pearson
- Steven B Pearson
- Theodore M Peck
- Joseph Alexander Pecoraro
- Connor Pedersen
- Jacob Matthew Pederson
- Marissa Pederson
- Susan Marie Pederson
- Bette J Pedretti
- Tanya Lynn Pedretti
All providers in La Crosse, WI · Student in an Organized Health Care Education/Training Program in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 1, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.