Individual provider Active NPI

Faye Tomimbang Pedersen, MD

  • Emergency Medicine Physician
  • Jefferson Hills, PA
National Provider Identifier
1609261791
Registry record updated Aug 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD464876 Issued in PA
Practice address
565 Coal Valley Rd
Jefferson Hills, PA 15025
Phone
(412) 469-5000
NPI assigned
Apr 6, 2015
Last updated
Aug 13, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD464876 PA Primary

Addresses

Primary practice location

565 Coal Valley Rd
Jefferson Hills, PA 15025

Mailing address

1362 Federal St
Pittsburgh, PA 15212-4755

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, WV2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20180815000108 PA Practitioner - Emergency Medicine 8426338096 Reassigns benefits to 1 organization
I20250423001138 WV Practitioner - Emergency Medicine 8426338096 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Camden-Clark Physician CorporationGroup PAC ID 5294885661, 345 clinicians

Practice addresses (Care Compare)

800 Garfield Ave
Parkersburg, WV 26101-5376
Phone (304) 424-2111

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.6 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD464876PAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dubois Regional Medical Center CurrentSince Apr 20, 2023 Accepting new patients
Camden-Clark Physician Corporation CurrentSince Apr 1, 2025 Accepting new patients
Dubois Regional Medical Center Emergency Medicine CurrentSince Apr 20, 2023 Accepting new patients

Locations

809 Turnpike Ave
Clearfield, PA 16830
Phone (814) 765-5341

100 Hospital Ave
Dubois, PA 15801
Phone (814) 375-2040

100 Hospital Ave
Ofc
Dubois, PA 15801

800 Garfield Ave
Parkersburg, WV 26101
Phone (304) 420-7161

800 Garfield Ave
Rm G101
Parkersburg, WV 26101
Phone (304) 422-0405

Organizations & group practices 4

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1428278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534118400000",
    "number": "1609261791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1362 FEDERAL ST",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152124755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 COAL VALLEY RD",
            "city": "JEFFERSON HILLS",
            "state": "PA",
            "postal_code": "15025",
            "telephone_number": "412-469-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "FAYE",
        "middle_name": "TOMIMBANG",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-06",
        "last_updated": "2018-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "MD464876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jefferson Hills, PA

Sources for this page

Verify at the official NPI Registry.