DR. ROBERT MELVIN PEDERSON D.D.S.
NPI 1063529808
Dentist - General Practice in Mondovi, WI

Q: What is Robert Pederson's NPI number?

The NPI number for Robert Pederson is 1063529808. It was assigned to this individual provider in the NPPES registry on August 25, 2006.

Q: What is Robert Pederson's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Robert Pederson was last updated on July 9, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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 August 25, 2006PECOS Enrolled

853 W MAIN ST, MONDOVI, WI 54755(715) 926-6035 Get Directions Write a Review

NPPES record last updated: July 9, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Dr. Robert Melvin Pederson D.d.s. NPPES

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

DR. ROBERT MELVIN PEDERSON D.D.S. (NPI 1063529808) is an individual general practice provider in Mondovi, Wisconsin, licensed in Wisconsin (4062-015) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1063529808

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameDR. ROBERT MELVIN PEDERSONCredential: D.D.S.

Location Address853 W MAIN STMondovi, WI 54755-1429

Mailing Address853 W Main StMondovi, WI 54755-1429 · (715) 926-6035

Phone(715) 926-6035

Sole ProprietorYes

Enumeration DateAugust 25, 2006

Last NPPES UpdateJuly 9, 2007

✔ NPI 1063529808 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in WI · 4062-015

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

853 W MAIN ST, Mondovi, WI 54755

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Other Identifiers 1

Medicaid33687500WI

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Delta Dental of Wisconsin, Inc., Guardian and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Robert Melvin Pederson D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 54755 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$82.92 typical visit price

range $53.90 – $163.24

Typical copayment $20.73 (range $13.47 – $40.81)

Most-billed visit code 99203

Established Patient

$67.37 typical visit price

range $17.40 – $133.76

Typical copayment $16.84 (range $4.35 – $33.44)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Robert Pederson's NPI number?

The NPI number for Robert Pederson is 1063529808. It was assigned to this individual provider in the NPPES registry on August 25, 2006.

Where is Robert Pederson located?

Robert Pederson practices at 853 W Main St, Mondovi, WI 54755. The listed phone number is (715) 926-6035.

What is Robert Pederson's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Robert Pederson enrolled in Medicare?

Yes. Robert Pederson is registered in the Medicare PECOS enrollment system.

What insurance does Robert Pederson accept?

Health plans from Anthem Blue Cross and Blue Shield, Delta Dental of Wisconsin, Inc., Guardian and Humana list Robert Pederson 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.

When was this NPI record last updated?

The NPPES record for Robert Pederson was last updated on July 9, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.