Anita M Pedersen, MD

Primary specialty

Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X

License

MD-16097 Issued in HI

Practice address

1 Jarrett White Rd
Department of Pediatrics, MCHK-Pe
Tripler Army Medical Center, HI 96859

Phone

(808) 433-6407

Fax

(808) 433-4837

NPI assigned

Mar 23, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in HI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Hawaii Permanente Medical Group Inc

  • Health Maintenance Organization
  • Honolulu, HI
  • NPI 1710945969
  Medicare reassignment NPD

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507075200000",
    "number": "1710947965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 S KAINALU DR",
            "city": "KAILUA",
            "state": "HI",
            "postal_code": "967342722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 JARRETT WHITE RD",
            "address_2": "DEPARTMENT OF PEDIATRICS, MCHK-PE",
            "city": "TRIPLER ARMY MEDICAL CENTER",
            "state": "HI",
            "postal_code": "96859",
            "telephone_number": "808-433-6407",
            "fax_number": "808-433-4837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "ANITA",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-23",
        "last_updated": "2017-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "HI",
            "license": "MD-16097",
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "HI",
            "license": "MD-16097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "MD-16097",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stacie Pascual, PHARM.D.
• Jeanette Emily Paterson, MD
• Erica Marie Payton, APRN, CPNP-AC
• Jamie Nicole Pechek, RN
• Alexander James Peckham IV, MD
• Joshua Pekelo, PHARMD
• Kasmyne Pender, LMSW, LCSW
• Kimi Y-K Perez, MS CCC-SLP LSLS AVT
• Angela Hope Perryman, LCSW
• Brandon Petersen, OTD

• Pediatric Endocrinology Physician in Tripler Army Medical Center, HI
• Providers in Tripler Army Medical Center, HI by specialty
• Pediatric Endocrinology Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2017; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.