Samantha Ellen Pederson, PA-C - Medicare Physician Assistant in Henderson, NE

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Samantha Ellen Pederson, PA-C is a medicare enrolled "Physician Assistant - Medical" physician in Henderson, Nebraska. She graduated from medical school in 2020 and has 6 years of diverse experience with area of expertise as Physician Assistant. Her current practice location is 1621 Front St, Henderson, Nebraska. You can reach out to her office (for appointments etc.) via phone at (402) 723-4512.

Samantha Ellen Pederson is licensed to practice in Nebraska (license number 2565) and she also participates in the medicare program. She may accept medicare assignments (which means she may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and her NPI Number is 1033885504.

Contact Information

Samantha Ellen Pederson, PA-C
1621 Front St,
Henderson, NE 68371-8902
(402) 723-4512
(402) 723-4520

Map and Direction




Physician's Profile

Full NameSamantha Ellen Pederson
GenderFemale
SpecialityPhysician Assistant
Experience6 Years
Location1621 Front St, Henderson, Nebraska
Accepts Medicare AssignmentsMay be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Samantha Ellen Pederson graduated from medical school in 2020
  NPI Data:
  • NPI Number: 1033885504
  • Provider Enumeration Date: 08/17/2021
  • Last Update Date: 06/30/2026
  Medicare PECOS Information:
  • PECOS PAC ID: 9133525934
  • Enrollment ID: I20210902000662

Medical Identifiers

Medical identifiers for Samantha Ellen Pederson such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1033885504NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207Q00000XFamily Medicine 2565 (Nebraska)Secondary
363AM0700XPhysician Assistant - Medical 2565 (Nebraska)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Bryan Medical CenterLincoln, NEHospital

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. Samantha Ellen Pederson allows following entities to bill medicare on her behalf.
Entity NameAlegent Creighton Clinic
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1548287907
PECOS PAC ID: 1951210418
Enrollment ID: O20040407001314
Entity NameEdgewood Family Physicians PC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1508829300
PECOS PAC ID: 5395816979
Enrollment ID: O20080625000688

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. Samantha Ellen Pederson 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 AddressPractice Location Address
Samantha Ellen Pederson, PA-C
1621 Front St,
Henderson, NE 68371-8902

Ph: (402) 723-4512		Samantha Ellen Pederson, PA-C
1621 Front St,
Henderson, NE 68371-8902

Ph: (402) 723-4512

Reviews and Comments



Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.