Active NPI
Jon F Pederson, OD
- Corneal and Contact Management Optometrist
- Centennial, CO
National Provider Identifier
1407842628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Corneal and Contact Management Optometrist
- License
- 2468
- Practice address
- 6650 S Vine St Ste 160
Centennial, CO 80121-2769 - Phone
- (303) 798-5533
- NPI assigned
- Sep 22, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Corneal and Contact Management Optometrist | 152WC0802X | 2468 | CO | Primary |
Addresses
Primary practice location
6650 S Vine St Ste 160
Centennial, CO 80121-2769
Mailing address
1410 S Columbine St
Denver, CO 80210-2419
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Pacific University - College of Optometry, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
7940 S University Blvd
Suite 100
Centennial, CO 80122-5104
Phone (303) 798-5533
Merit-based Incentive Payment System (MIPS)
- Final score
- 83.54 of 100
- Quality
- 67.08
- Improvement activities
- 40
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Cataract surgery | 40 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2468 | CO | MD | Psychologist |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1613433600000",
"number": "1407842628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1410 S COLUMBINE ST",
"city": "DENVER",
"state": "CO",
"postal_code": "802102419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6650 S VINE ST STE 160",
"city": "CENTENNIAL",
"state": "CO",
"postal_code": "801212769",
"telephone_number": "303-798-5533"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEDERSON",
"first_name": "JON",
"middle_name": "F",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-22",
"last_updated": "2021-02-16",
"certification_date": "2021-02-16",
"status": "A"
},
"taxonomies": [
{
"code": "152WC0802X",
"taxonomy_group": "",
"desc": "Optometrist, Corneal and Contact Management",
"state": "CO",
"license": "2468",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Centennial, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2021; 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.
- 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.