Daniel A Pedersen, DO

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

OS021569 Issued in PA

Practice address

200 Schuylkill Medical PLZ
Pottsville, PA 17901-3660

Phone

(570) 621-9270

Fax

(570) 621-9271

NPI assigned

Aug 30, 2011

Last updated

Nov 27, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Rowan University School of Osteopathic Medicine, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lehigh Valley Physician GroupGroup PAC ID 3072425123, 2,512 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Rocky Mountain Home Care-Green River Home health agency, Green River, WY, CCN 537302
• Schuylkill Medical Center - South Jackson Street Hospital, Pottsville, PA, CCN 390030

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dpedersen601993@direct2.lvhn.org

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.

• Lehigh Valley Physician Group

  dba LVPG Developmental Pediatrics

  • Developmental - Behavioral Pediatrics Physician
  • Allentown, PA
  • NPI 1780155689
  Medicare reassignment Care Compare group
• Schuylkill Health System Medical Group, Inc.

  dba Lehigh Valley Physician Group-Schuylkill

  • Internal Medicine Physician
  • Pottsville, PA
  • NPI 1588603567

  Family Medicine

  Medicare reassignment NPD
• Pedersen Family Medicine, LLC

  • Family Medicine Physician
  • Vineland, NJ
  • NPI 1497123418
  Authorized official Same address or phone
• Lehigh Valley Physician Group

  dba LVPG Family Medicine - Hamburg

  • Family Medicine Physician
  • Hamburg, PA
  • NPI 1134218209
  NPD
• Lehigh Valley Physician Group

  dba LVPG Family and Internal Medicine - East Stroudsburg

  • Family Medicine Physician
  • East Stroudsburg, PA
  • NPI 1245093368
  NPD
• Lehigh Valley Physician Group

  • Transplant Surgery Physician
  • Allentown, PA
  • NPI 1457309650

  Family Medicine

  NPD
• Schuylkill Health System Medical Group, Inc.

  dba LVPG ExpressCare Schuylkill

  • Emergency Medicine Physician
  • Pottsville, PA
  • NPI 1063073823

  Family Medicine

  NPD
• Inspira Health Network Medical Group, P.C.

  dba Inspira Medical Group

  • Multi-Specialty Clinic/Center
  • Glassboro, NJ
  • NPI 1922177856
  NPD (past)

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

• Lehigh Valley Hospital - Schuylkill

  dba Lehigh Valley Hospital Schuylkill S Jackson Street

  • Rural Acute Care Hospital
  • Pottsville, PA
  • NPI 1235138405
  Care Compare affiliation
• Schuylkill Medical Center - East Norweigan Street

  • General Acute Care Hospital
  • Pottsville, PA
  • NPI 1427050376
  Care Compare affiliation
• Bcbu, Inc.

  dba Rocky Mountain Home Care - Green River

  • Home Health Agency
  • Green River, WY
  • NPI 1811994122
  Care Compare affiliation

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

{
    "created_epoch": "1314662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1790066108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450E CHESTNUT AVE 3D",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083618469",
            "telephone_number": "856-692-0050",
            "fax_number": "856-692-0081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SCHUYLKILL MEDICAL PLZ",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179013660",
            "telephone_number": "570-621-9270",
            "fax_number": "570-621-9271"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1791 Airport Rd",
            "address_purpose": "LOCATION",
            "city": "Allentown",
            "state": "PA",
            "postal_code": "181099528",
            "country_code": "US",
            "telephone_number": "610-264-5844",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1450E CHESTNUT AVE 3D",
            "address_purpose": "LOCATION",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083618469",
            "country_code": "US",
            "telephone_number": "856-692-0050",
            "fax_number": "856-692-0081",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "DANIEL",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-30",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "OS021569",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB09405100",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pamela Guers Palko
• Monika Parikh, PH.D.
• Glicelyn Cerezo Pascual
• David Michael Pastucka, MA
• Sachin B Patel, MD
• Denise Peifer
• Pennsylvania CVS Pharmacy, L.L.C. (CVS Pharmacy #01323)
• Pennsylvania CVS Pharmacy, L.L.C. (CVS Pharmacy #01324)
• Jamison Perkins, DPT
• Peter P Sidoriak

• Family Medicine Physician in Pottsville, PA
• Providers in Pottsville, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.