Eric Pederson, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

12132 Issued in SD

Practice address

502 E Monroe St
Rapid City, SD 57701-1400

Phone

(605) 755-4060

Fax

(605) 755-4012

NPI assigned

May 31, 2017

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 NC

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 1

Specialty

Family Practice

Education

Alabama College of Osteopathic Medicine, 2017

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

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.

• Centerwell Senior Primary Care (NC) PC

  • Internal Medicine Physician
  • Orlando, FL
  • NPI 1811418445

  Family Medicine

  NPD (past)

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

{
    "created_epoch": "1496188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1679001945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 E MONROE ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577011400",
            "telephone_number": "605-755-4060",
            "fax_number": "605-755-4012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 E MONROE ST",
            "city": "RAPID CITY",
            "state": "SD",
            "postal_code": "577011400",
            "telephone_number": "605-755-4060",
            "fax_number": "605-755-4012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSON",
        "first_name": "ERIC",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-31",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SD",
            "license": "12132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Paulsen, CNP
• Peak Vitality Counseling Services
• Estel Pearce
• Jared Carl Pearson, O.D.
• Heather Rae Peck, M.D.
• Pediatric Counseling and Consultation LLC
• Erika Pehrson
• Peloton Anesthesia, PLLC
• Molly Rae Pengra, PT, DPT
• Pennington County Auditor

• Family Medicine Physician in Rapid City, SD
• Providers in Rapid City, SD by specialty
• Family Medicine Physician in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2020; 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.

Verify at the official NPI Registry.