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JENNA PEDERSON
NPI 1063966158
Nurse Practitioner - Family in Oak Park, IL

Active since August 07, 2016PECOS Enrolled
3 ERIE CT STE 1300, OAK PARK, IL 60302(708) 406-3929(708) 406-3935 Get Directions Write a Review

NPPES record last updated: January 2, 2020. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Jenna Pederson NPPES

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

JENNA PEDERSON (NPI 1063966158) is an individual family provider in Oak Park, Illinois, licensed in Illinois (209.014598) and active in the NPI registry since August 2016. She is enrolled in Medicare PECOS, maintains a secondary practice location in Oak Park, and is a graduate of Rush Medical College Of Rush University (2011).

NPPES Registry Identity

NPI1063966158
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameJENNA PEDERSON
Location Address3 ERIE CT STE 1300Oak Park, IL 60302-2519
Mailing Address641 W Grand Ave Apt 4Chicago, IL 60654-5534 · (612) 205-7959
Phone(708) 406-3929
Fax(708) 406-3935
Sole ProprietorNo
Medical School CMSRush Medical College Of Rush UniversityGraduated 2011
Enumeration DateAugust 7, 2016
Last NPPES UpdateJanuary 2, 2020
✔ NPI 1063966158 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in IL · 209.014598
3 ERIE CT STE 1300, Oak Park, IL 60302
Open in Google Maps ↗

Secondary Practice Location 1

Location 114 Lake StOak Park, IL 60302-2606 · Phone (708) 383-9911

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jenna Pederson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4880973742
PECOS Enrollment IDI20251119000648
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 Reassignments

3

Medicare enrollment records show Jenna Pederson reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Pcc Community Wellness Center
0.9 mi
Federally Qualified Health Center (FQHC)
14 LAKE ST
Oak Park, IL 60302
  • Reassigned Medicare billing, Illinois enrollment
  • 221 clinicians in this Medicare group
NPI 1871516799 (708) 383-0113
Rush University Medical Center
6.4 mi
Diagnostic Radiology
1620 W HARRISON ST
Chicago, IL 60612
  • Reassigned Medicare billing, Illinois enrollment
  • Medicare enrollment name: Rush University Medical Group
  • 2,169 clinicians in this Medicare group
NPI 1184269425 (312) 563-4270
Signify Health Medical Associates, PLLC
793 mi
General Practice
4055 VALLEY VIEW LN STE 700
Dallas, TX 75244
  • Reassigned Medicare billing, Illinois and Minnesota enrollments
  • 712 clinicians in this Medicare group
NPI 1750845863 (972) 715-3800

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60302 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
$94.06 typical visit price
range $60.08 – $183.39
Typical copayment $23.51 (range $15.02 – $45.84)
Most-billed visit code 99203
Established Patient
$105.70 typical visit price
range $18.97 – $148.12
Typical copayment $26.42 (range $4.74 – $37.03)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 6

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

MR. MISTEAD TORGBOR SAI MSW
Social Worker (Clinical)
3 ERIE CT STE 1300
OAK PARK, IL 60302
Cook County (708) 406-3929
ANDREW WOJDA LCSW
Social Worker (Clinical)
3 ERIE CT STE 1300
OAK PARK, IL 60302
Cook County (708) 406-3929
MATTHEW Q ENGLISH
Social Worker (Clinical)
3 ERIE CT STE 1300
OAK PARK, IL 60302
Cook County (708) 406-3929
HEALTHCARE ALTERNATIVE SYSTEMS, INC.
Clinic/Center (Rehabilitation, Substance Use Disorder)
3 ERIE CT STE 1300
OAK PARK, IL 60302
Cook County (773) 252-3100
DR. AMRIT KAUR RAO M.D.
Family Medicine
3 ERIE CT STE 1300
OAK PARK, IL 60302
Cook County (708) 406-3929
TICHINA R SMITH LSW
Social Worker
3 ERIE CT STE 1300
OAK PARK, IL 60302
Cook County (708) 406-3929

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 Jenna Pederson's NPI number?

The NPI number for Jenna Pederson is 1063966158. It was assigned to this individual provider in the NPPES registry on August 7, 2016.

Where is Jenna Pederson located?

Jenna Pederson practices at 3 Erie Ct Ste 1300, Oak Park, IL 60302. The listed phone number is (708) 406-3929.

What is Jenna Pederson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Jenna Pederson enrolled in Medicare?

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

Which organizations bill Medicare for Jenna Pederson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jenna Pederson reassigns Medicare benefits to 3 organizations: Pcc Community Wellness Center (Oak Park, IL), Rush University Medical Center (Chicago, IL) and Signify Health Medical Associates, PLLC (Dallas, TX). Each 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 Jenna Pederson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jenna Pederson was last updated on January 2, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.