Nicholas Pedersen, is a medicare enrolled "Physician Assistant" in Cumberland, Wisconsin. He graduated from nursing school in 2020 and has 6 years of diverse experience with area of expertise as Physician Assistant. He is a member of the group practice Cumberland Memorial Hospital Inc and his current practice location is
1705 16th Ave, Cumberland, Wisconsin. You can reach out to his office (for appointments etc.) via phone at
(715) 822-7500.
Nicholas Pedersen is licensed to practice in Wisconsin (license number 5071) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1619502275.
Provider's Profile
| Full Name | Nicholas Pedersen |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Experience | 6 Years |
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| Location | 1705 16th Ave, Cumberland, Wisconsin |
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| Accepts Medicare Assignments | Yes. He 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:
- Nicholas Pedersen graduated from nursing school in 2020
NPI Data:
- NPI Number: 1619502275
- Provider Enumeration Date: 03/04/2020
- Last Update Date: 03/24/2026
Medicare PECOS Information:
- PECOS PAC ID: 0446674097
- Enrollment ID: I20200716000375
Medical Identifiers
Medical identifiers for Nicholas Pedersen such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1619502275 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363A00000X | Physician Assistant | 5071 (Wisconsin) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Cumberland Memorial Hospital Inc | 7719889203 | 19 |
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. Nicholas Pedersen allows following entities to bill medicare on his behalf.
| Entity Name | Cumberland Memorial Hospital Inc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1831243757
PECOS PAC ID: 7719889203
Enrollment ID: O20040124000061 |
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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. Nicholas 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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Nicholas Pedersen,
1705 16th Ave,
Cumberland, WI 54829-8601
Ph: (715) 822-7500 | Nicholas Pedersen,
1705 16th Ave,
Cumberland, WI 54829-8601
Ph: (715) 822-7500 |
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