Coralie Ann Pederson, WHNP in Minneapolis, MN

Coralie Ann Pederson, WHNP is a medicare enrolled "Nurse Practitioner" in Minneapolis, Minnesota. Her current practice location is 410 Church St Se, Minneapolis, Minnesota. You can reach out to her office (for appointments etc.) via phone at (612) 625-8400.

Coralie Ann Pederson is licensed to practice in Minnesota (license number R131630-8) 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 1841283074.

Contact Information

	Coralie Ann Pederson, WHNP
	410 Church St Se, Minneapolis, MN 55455-0222
	(612) 625-8400
	(612) 677-3321

Map and Direction

Provider's Profile

Full Name	Coralie Ann Pederson
Gender	Female
Speciality	Nurse Practitioner
Location	410 Church St Se, Minneapolis, Minnesota
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1841283074
Provider Enumeration Date: 08/23/2005
Last Update Date: 09/17/2024

Medicare PECOS Information:

PECOS PAC ID: 1759718349
Enrollment ID: I20200220000700

Medical Identifiers

Medical identifiers for Coralie Ann Pederson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1841283074	NPI	-	NPPES
463972300	Medicaid	MN

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	R131630-8 (Minnesota)	Primary

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. Coralie Ann Pederson allows following entities to bill medicare on her behalf.

Entity Name	Regents Of The University Of Minnesota
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1114019858 PECOS PAC ID: 7416856059 Enrollment ID: O20040102000679

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. Coralie Ann 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 Address	Practice Location Address
Coralie Ann Pederson, WHNP 410 Church St Se, Minneapolis, MN 55455-0222 Ph: (612) 625-8400	Coralie Ann Pederson, WHNP 410 Church St Se, Minneapolis, MN 55455-0222 Ph: (612) 625-8400

Reviews and Comments

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Coralie Ann Pederson, WHNP - Medicare Nurse Practitioner in Minneapolis, MN