| Mr Gerald Pedersen, CRNA | |
|
6300 Main St, Zachary, LA 70791-4037 | |
| (225) 658-4000 | |
| Not Available |
| Full Name | Mr Gerald Pedersen |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 40 Years |
| Location | 6300 Main St, Zachary, Louisiana |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093758716 | NPI | - | NPPES |
| AN3110 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 23775 (South Carolina) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 44332 (Louisiana) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| The Spine Hospital Of Louisiana | Baton rouge, LA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Dpi Of Louisiana Llc | 1456886365 | 52 |
| Nuedge Anesthesia Llc | 7911340575 | 14 |
| Entity Name | Hospital Service District No. 1 Of Iberia Parish |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780690180 PECOS PAC ID: 4688659188 Enrollment ID: O20040621000102 |
| Entity Name | Riverside Anesthesia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1518918556 PECOS PAC ID: 3476527946 Enrollment ID: O20040820000805 |
| Entity Name | Diversified Professionals, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700923992 PECOS PAC ID: 0446356463 Enrollment ID: O20070507000647 |
| Entity Name | Nuedge Anesthesia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629759782 PECOS PAC ID: 7911340575 Enrollment ID: O20240210000211 |
| Entity Name | Dpi Of Louisiana Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144083387 PECOS PAC ID: 1456886365 Enrollment ID: O20241130000133 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Gerald Pedersen, CRNA 3617 Hyacinth Ave, Baton Rouge, LA 70808-2933 Ph: (225) 389-2928 | Mr Gerald Pedersen, CRNA 6300 Main St, Zachary, LA 70791-4037 Ph: (225) 658-4000 |
James Chustz, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 6300 Main St, Zachary, LA 70791 Phone: 225-658-4000 Fax: 225-658-4274 | |
Frank Baxter Ragsdale, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 6300 Main St, Zachary, LA 70791 Phone: 225-658-4437 Fax: 225-658-4181 |