NPIMap

Individual provider Active NPI

Chad A Pedersen, MD

  • Medical Oncology Physician
  • Watford City, ND
National Provider Identifier
1881857019
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
21785 Issued in ND
Practice address
709 4TH Ave NE
Watford City, ND 58854-7628
Phone
(701) 842-3000
Fax
(701) 842-4025
NPI assigned
Jul 8, 2008
Last updated
Feb 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 55437 WI
Internal Medicine Physician 207R00000X 60620 MT
Hematology (Internal Medicine) Physician 207RH0000X 60620 MT
Medical Oncology Physician 207RX0202X 60620 MT
Medical Oncology Physician 207RX0202X 21785 ND Primary

Addresses

Primary practice location

709 4TH Ave NE
Watford City, ND 58854-7628

Mailing address

1836 South Ave
La Crosse, WI 54601-5429
Phone (608) 782-7300

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address cpedersen10541495@direct.sanfordhealth.org Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241120000835 ND Practitioner - Medical Oncology 6800065137 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Medical Oncology
Education
University of North Dakota School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McKenzie County Healthcare Systems IncGroup PAC ID 5890768006, shared by 5 NPIs, 63 clinicians

Practice addresses (Care Compare)

709 4TH Ave NE
Watford City, ND 58854-7628
Phone (701) 842-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
55437WIMDInternal Medicine Physician
60620MTMDHematology (Internal Medicine) Physician
21785NDMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
McKenzie County Healthcare Systems Inc CurrentSince Dec 1, 2024 Accepting new patients
McKenzie County Healthcare Systems Inc CurrentSince Dec 1, 2024 Accepting new patients
McKenzie County Healthcare Systems Inc Internal Medicine Current Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients
McKenzie County Healthcare Systems Inc Past Accepting new patients
Frances Mahon Deaconess Hospital Past Accepting new patients

Locations

1002 18th Ave SE
Ste C
Minot, ND 58701
Phone (701) 857-6010

525 N Main St
Watford City, ND 58854
Phone (701) 842-3771

709 4th Ave NE
Watford City, ND 58854
Phone (701) 444-2331

1542 16th St W
Ste 300
Williston, ND 58801
Phone (701) 572-2470

Interoperability endpoints

  • Direct secure messaging: cpedersen10541495@direct.sanfordhealth.org

Organizations & group practices 8

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 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1881857019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 SOUTH AVE",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546015429",
            "telephone_number": "608-782-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "709 4TH AVE NE",
            "city": "WATFORD CITY",
            "state": "ND",
            "postal_code": "588547628",
            "telephone_number": "701-842-3000",
            "fax_number": "701-842-4025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "CHAD",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-08",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "55437",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MT",
            "license": "60620",
            "primary": false
        },
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "MT",
            "license": "60620",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "MT",
            "license": "60620",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "ND",
            "license": "21785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "cpedersen10541495@direct.sanfordhealth.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCDA",
            "address_1": "214 14th Ave SW",
            "city": "Sidney",
            "state": "MT",
            "country_code": "US",
            "postal_code": "592703521",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Watford City, ND

Sources for this page

Verify at the official NPI Registry.