Mr Jacob Kohl Pederson, APRN CNP in Fargo, ND

Mr Jacob Kohl Pederson, APRN CNP is a medicare enrolled "Nurse Practitioner - Gerontology" in Fargo, North Dakota. He graduated from nursing school in 2021 and has 3 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Cuyuna Regional Medical Center and his current practice location is 3000 32nd Ave S, Fargo, North Dakota. You can reach out to his office (for appointments etc.) via phone at (701) 364-8000.

Mr Jacob Kohl Pederson is licensed to practice in North Dakota (license number R51672) 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 1770243727.

Contact Information

	Mr Jacob Kohl Pederson, APRN CNP
	3000 32nd Ave S, Fargo, ND 58103-6132
	(701) 364-8000
	Not Available

Map and Direction

Provider's Profile

Full Name	Mr Jacob Kohl Pederson
Gender	Male
Speciality	Nurse Practitioner
Experience	3 Years
Location	3000 32nd Ave S, Fargo, North Dakota
Accepts Medicare Assignments	Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mr Jacob Kohl Pederson graduated from nursing school in 2021

NPI Data:

NPI Number: 1770243727
Provider Enumeration Date: 12/17/2021
Last Update Date: 12/17/2021

Medicare PECOS Information:

PECOS PAC ID: 3072905892
Enrollment ID: I20230907003887

Medical Identifiers

Medical identifiers for Mr Jacob Kohl Pederson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1770243727	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LG0600X	Nurse Practitioner - Gerontology	R51672 (North Dakota)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Essentia Health	Fargo, ND	Hospital
Cuyuna Regional Medical Center	Crosby, MN	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Cuyuna Regional Medical Center	9537146550	106

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. Mr Jacob Kohl Pederson allows following entities to bill medicare on his behalf.

Entity Name	Cuyuna Regional Medical Center
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1861414518 PECOS PAC ID: 9537146550 Enrollment ID: O20040707000501

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. Mr Jacob Kohl 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
Mr Jacob Kohl Pederson, APRN CNP 400 E 3rd St, Duluth, MN 55805-1951 Ph: (218) 786-8364	Mr Jacob Kohl Pederson, APRN CNP 3000 32nd Ave S, Fargo, ND 58103-6132 Ph: (701) 364-8000

Reviews and Comments

Nurse Practitioner Nurses in Fargo, ND

Wendy M Moore, NURSE PRACTITIONER Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 901 28th St S, Fargo, ND 58103 Phone: 701-404-1100 Fax: 701-540-6498
Mrs. Kayla L. Nelson, DNP, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 301 Np Ave N, Fargo, ND 58102 Phone: 701-271-3344
Kyrie Marie Severson, APRN, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4622 40th Ave S, Suite A, Fargo, ND 58104 Phone: 701-364-2909 Fax: 701-364-9822
Jessica Smolen, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 321 8th Ave N, Fargo, ND 58102 Phone: 701-234-2525
Mary Omer Habib, APRN, CNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 4622 40th Ave S Ste A, Fargo, ND 58104 Phone: 218-364-8900
Mr. Nicholas Henry Frederiksen, APRN,CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3000 32nd Ave S, Fargo, ND 58103 Phone: 701-364-8000 Fax: 701-364-8078
Erin Marie Wilmes Reiniger, APRN, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 4622 40th Ave S, Fargo, ND 58104 Phone: 701-364-8000 Fax: 701-364-3561

Mr Jacob Kohl Pederson, APRN CNP - Medicare Nurse Practitioner in Fargo, ND