Dr Taylor Nicole Pedersen, DO is a medicare enrolled "Family Medicine" physician in Buffalo, Missouri. Her current practice location is
201 S Ash St, Buffalo, Missouri. You can reach out to her office (for appointments etc.) via phone at
(417) 345-4858.
Dr Taylor Nicole Pedersen is licensed to practice in Missouri (license number 2020009910) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1043740202.
Physician's Profile
| Full Name | Dr Taylor Nicole Pedersen |
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| Gender | Female |
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| Speciality | Family Medicine |
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| Location | 201 S Ash St, Buffalo, Missouri |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1043740202
- Provider Enumeration Date: 06/19/2017
- Last Update Date: 03/02/2026
Medicare PECOS Information:
- PECOS PAC ID: 4284978420
- Enrollment ID: I20200915003381
Medical Identifiers
Medical identifiers for Dr Taylor Nicole Pedersen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1043740202 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | 2020009910 (Missouri) | Primary |
| 207Q00000X | Family Medicine | 12327A (Wyoming) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Taylor Nicole Pedersen allows following entities to bill medicare on her behalf.
| Entity Name | Citizens Memorial Healthcare |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1568566131
PECOS PAC ID: 4183528169
Enrollment ID: O20040315001374 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Taylor Nicole Pedersen is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Taylor Nicole Pedersen, DO
201 S Ash St,
Buffalo, MO 65622-8674
Ph: (417) 345-4858 | Dr Taylor Nicole Pedersen, DO
201 S Ash St,
Buffalo, MO 65622-8674
Ph: (417) 345-4858 |
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