David Andrew Pedersen, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

23255 Issued in AZ

Practice address

1712 W Anklam Rd
Ste 103
Tucson, AZ 85745-2660

Phone

(520) 622-7384

Fax

(520) 622-4899

NPI assigned

Apr 25, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

General Surgery

Education

University of Arizona College of Medicine, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tucson Physician Group Holdings LLCGroup PAC ID 0547560070, 200 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St. Mary'S Hospital Hospital, Tucson, AZ, CCN 030010

Merit-based Incentive Payment System (MIPS)

Final score

84.74 of 100Reported as group

Quality

79.16

Promoting interoperability

100

Improvement activities

40

Cost

69.96

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dpedersen192706@direct.tmcaz.com
• Direct secure messaging: david.pedersen.1@600.direct.athenahealth.com
• FHIR API: https://fhir-myrecord.cerner.com/r4/MmWbh382tKlbvAIA1_DeLlIjYVSwroch/

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.

• Tucson Physician Group Holdings, LLC

  • Interventional Cardiology Physician
  • Tucson, AZ
  • NPI 1356726939
  Medicare reassignment Care Compare group NPD
• Arizona Community Surgeons PC

  • Surgery Physician
  • Tucson, AZ
  • NPI 1689616070
  Medicare reassignment NPD
• Carondelet Medical Group, Inc

  • Family Medicine Physician
  • Tucson, AZ
  • NPI 1659326585
  NPD (past)
• Valley ENT, PC

  • Otolaryngology Physician
  • Scottsdale, AZ
  • NPI 1508990185
  NPD (past)

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

• SMSJ Tucson Holdings LLC

  • General Acute Care Hospital
  • Tucson, AZ
  • NPI 1265818488
  Care Compare affiliation

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668729600000",
    "number": "1972569200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1712 W ANKLAM RD",
            "address_2": "STE 103",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452660",
            "telephone_number": "520-622-7384",
            "fax_number": "520-622-4899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1712 W ANKLAM RD",
            "address_2": "STE 103",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857452660",
            "telephone_number": "520-622-7384",
            "fax_number": "520-622-4899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEDERSEN",
        "first_name": "DAVID",
        "middle_name": "ANDREW",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-25",
        "last_updated": "2022-11-18",
        "certification_date": "2022-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AZ",
            "license": "23255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "313099",
            "state": "AZ"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dpedersen192706@direct.tmcaz.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1712 W Anklam Rd",
            "address_2": "STE 103",
            "city": "Tucson",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "857452660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Michael Lawrence Peck, FNP-C
• Andrew Peckham, NP
• Donald Lee Peckinpaugh, HAD5930
• Sean Pecoraro, DO, MPH
• Julia Peddy, LPC
• Pediatric Communication Services
• Pediatric Gastroenterology, PC
• Pediatric Playhouse
• Pediatric Psychology Associates, LTD.
• Pediatric Pulmonary Associates,PC

• Surgery Physician in Tucson, AZ
• Providers in Tucson, AZ by specialty
• Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2022; 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.