Katelyn Joy Pedersen, ARNP is a medicare enrolled "Family Medicine" in Eugene, Oregon. She graduated from nursing school in 2020 and has 5 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Optum Care Washington Pllc, Oregon Healthcare Resources Llc and her current practice location is
2830 Crescent Ave, Eugene, Oregon. You can reach out to her office (for appointments etc.) via phone at
(541) 686-9000.
Katelyn Joy Pedersen is licensed to practice in Oregon (license number 10024575) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1063021137.
Provider's Profile
| Full Name | Katelyn Joy Pedersen |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 5 Years |
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| Location | 2830 Crescent Ave, Eugene, Oregon |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Katelyn Joy Pedersen graduated from nursing school in 2020
NPI Data:
- NPI Number: 1063021137
- Provider Enumeration Date: 07/24/2020
- Last Update Date: 10/23/2025
Medicare PECOS Information:
- PECOS PAC ID: 9931528833
- Enrollment ID: I20200925001991
Medical Identifiers
Medical identifiers for Katelyn Joy Pedersen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1063021137 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363L00000X | Nurse Practitioner | AP61085962 (Washington) | Secondary |
| 207Q00000X | Family Medicine | 10024575 (Oregon) | Primary |
| 363LF0000X | Nurse Practitioner - Family | AP61085962 (Washington) | Secondary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Optum Care Washington Pllc | 6406752153 | 597 |
| Oregon Healthcare Resources Llc | 4486835477 | 117 |
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. Katelyn Joy Pedersen allows following entities to bill medicare on her behalf.
| Entity Name | The Polyclinic Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1174594634
PECOS PAC ID: 2163328196
Enrollment ID: O20031210000788 |
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| Entity Name | Optum Care Washington Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1831186766
PECOS PAC ID: 6406752153
Enrollment ID: O20031211000922 |
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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. Katelyn Joy 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 |
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Katelyn Joy Pedersen, ARNP
Po Box 1648,
Eugene, OR 97440-1648
Ph: (541) 242-4384 | Katelyn Joy Pedersen, ARNP
2830 Crescent Ave,
Eugene, OR 97408-7397
Ph: (541) 686-9000 |
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