PAUL CHRISTEN PEDERSEN M.D.
NPI 1003892720
General Practice in Barbourville, KY

Q: What is Paul Pedersen's NPI number?

The NPI number for Paul Pedersen is 1003892720. It was assigned to this individual provider in the NPPES registry on December 15, 2005.

Q: What is Paul Pedersen's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Q: When was this NPI record last updated?

The NPPES record for Paul Pedersen was last updated on December 7, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 15, 2005PECOS EnrolledAccepts Medicare Assignment

95.5/100

CMS Quality Rating

602 KNOX ST, BARBOURVILLE, KY 40906(606) 546-6027(606) 546-2084 Get Directions Write a Review

NPPES record last updated: December 7, 2020. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Dec 7, 2020, Feb 5, 2016 (2 updates tracked since 2016).

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About Paul Christen Pedersen M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PAUL CHRISTEN PEDERSEN M.D. (NPI 1003892720) is an individual general practice provider in Barbourville, Kentucky, licensed in Kentucky (31705) and active in the NPI registry since December 2005. He is enrolled in Medicare PECOS, is affiliated with Baptist Health Corbin, and is a graduate of Other (1992).

NPPES Registry Identity

NPI1003892720

Entity TypeIndividualMale

Primary Taxonomy208D00000X

Provider Legal NamePAUL CHRISTEN PEDERSENCredential: M.D.

Location Address602 KNOX STBarbourville, KY 40906-1304

Mailing AddressPo Box 1325Corbin, KY 40702-1325 · (606) 526-8131 · Fax (606) 528-8661

Phone(606) 546-6027

Fax(606) 546-2084

Sole ProprietorYes

Medical School CMSOtherGraduated 1992

Enumeration DateDecember 15, 2005

Last NPPES UpdateDecember 7, 20202 updates tracked since enumeration

NPPES CertifiedDecember 7, 2020

✔ NPI 1003892720 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians

Taxonomy Code208D00000X

License✔ Licensed in KY · 31705

Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

602 KNOX ST, Barbourville, KY 40906

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Other Identifiers 2

OtherP01427263KY · Rr Medicare

Medicaid64317050KY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter Health, Ambetter of Tennessee and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Paul Christen Pedersen M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6406835560

PECOS Enrollment IDI20040809000698

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Paul Pedersen reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Baptist Health Medical Group Inc

0.2 mi

Rural Health

602 KNOX ST
Barbourville, KY 40906

Reassigned Medicare billing, Kentucky enrollment
1,441 clinicians in this Medicare group

NPI 1184119398 (606) 546-6027

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Insertion of needle into vein for collection of blood sample 36415

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

66 services53 patients

Hemoglobin a1c level 83036

Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.

30 services27 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Baptist Health Corbin

Acute Care Hospitals · Corbin, KY

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number180080

LocationOne Trillium WayCorbin, KY 40701 · Whitley County

Emergency services Birthing friendly

Knox County Hospital

Critical Access Hospitals · Barbourville, KY

OwnershipGovernment - Local

CMS Certification Number181328

Location80 Hospital DriveBarbourville, KY 40906 · Knox County

Emergency services

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

95.5/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

89.59

Promoting Interoperability

100

Improvement Activities

Referred Medical Equipment & Supplies CMS DME claims 15

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

9 suppliers50 claims107 services$5.87 avg. paid by Medicare

Lancets, per box of 100 A4259

DME-Medical/Surgical Supplies · category DA000N

7 suppliers25 claims25 services$0.72 avg. paid by Medicare

For diabetics only, fitting (including follow-up), custom preparation and supply of off-the-shelf depth-inlay shoe manufactured to accommodate multi-density insert(s), per shoe A5500

DME-Orthotic Devices · category DF000N

3 suppliers11 claims22 services$57.97 avg. paid by Medicare

For diabetics only, multiple density insert, direct formed, molded to foot after external heat source of 230 degrees fahrenheit or higher, total contact with patient's foot, including arch, base layer minimum of 1/4 inch material of shore a 35 durometer or 3/16 inch material of shore a 40 durometer (or higher), prefabricated, each A5512

DME-Orthotic Devices · category DF000N

3 suppliers11 claims66 services$25.01 avg. paid by Medicare

Filter, disposable, used with positive airway pressure device A7038

DME-Other DME · category DE001N

3 suppliers23 claims54 services$3.22 avg. paid by Medicare

Hospital bed, semi-electric (head and foot adjustment), with any type side rails, with mattress E0260

DME-Hospital Beds · category DB000N

2 suppliers18 claims18 services$57.34 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MICHELLE LOUISE BROUGHTON APRN

Nurse Practitioner

602 KNOX ST
BARBOURVILLE, KY 40906

Knox County (606) 546-6027

AMANDA L HERRELL DO

Family Medicine

602 KNOX ST
BARBOURVILLE, KY 40906

Knox County (606) 546-6027

MR. JAMES RADFORD WEST JR. M.D.

Family Medicine

602 KNOX ST
BARBOURVILLE, KY 40906

Knox County (606) 546-6027

BAPTIST HEALTH MEDICAL GROUP INC

Clinic/Center (Rural Health)

602 KNOX ST
BARBOURVILLE, KY 40906

Knox County (606) 546-6027

MRS. CYNTHIA GOODIN APRN

Nurse Practitioner (Family)

602 KNOX ST
BARBOURVILLE, KY 40906

Knox County (606) 546-6027

KATHLEEN P. FLYNN PA-C

Physician Assistant

602 KNOX ST, KNOX FAMILY MEDICINE
BARBOURVILLE, KY 40906

Knox County (606) 546-6027

MRS. ANNE HUI PEDERSEN P.T.

Physical Therapist

602 KNOX ST
BARBOURVILLE, KY 40906

Knox County (606) 546-6027

KNOX FAMILY MEDICINE PSC

Family Medicine

602 KNOX ST
BARBOURVILLE, KY 40906

Knox County (606) 546-6027

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Paul Pedersen's NPI number?

The NPI number for Paul Pedersen is 1003892720. It was assigned to this individual provider in the NPPES registry on December 15, 2005.

Where is Paul Pedersen located?

Paul Pedersen practices at 602 Knox St, Barbourville, KY 40906. The listed phone number is (606) 546-6027.

What is Paul Pedersen's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

Is Paul Pedersen enrolled in Medicare?

Yes. Paul Pedersen is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Paul Pedersen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Paul Pedersen reassigns Medicare benefits to Baptist Health Medical Group Inc (Barbourville, KY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Paul Pedersen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Paul Pedersen accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter of Tennessee, Anthem Blue Cross and Blue Shield and CareSource list Paul Pedersen as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Paul Pedersen affiliated with any hospitals?

According to CMS data, Paul Pedersen is affiliated with Baptist Health Corbin and Knox County Hospital.

When was this NPI record last updated?

The NPPES record for Paul Pedersen was last updated on December 7, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.