TIMOTHY S PEDERSON MD
NPI 1154353399
Anesthesiology in Portland, OR
About Timothy S Pederson Md NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TIMOTHY S PEDERSON MD (NPI 1154353399) is an individual anesthesiology provider in Portland, Oregon, licensed in Oregon (MD154531) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and is a graduate of University Of Minnesota Medical School (2012).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
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
Timothy S Pederson Md 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.
Medicare Billing Reassignment
Medicare enrollment records show Timothy Pederson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Portland, OR 97209
- Reassigned Medicare billing, Oregon and Washington enrollments
- Also billed through NPI 1184786527 (Washington)
- 3,207 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 Timothy Pederson's NPI number?
The NPI number for Timothy Pederson is 1154353399. It was assigned to this individual provider in the NPPES registry on July 7, 2006.
Where is Timothy Pederson located?
Timothy Pederson practices at 707 SW Washington St Suite 700, Portland, OR 97205. The listed phone number is (503) 299-9906.
What is Timothy Pederson's specialty?
The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.
Is Timothy Pederson enrolled in Medicare?
Yes. Timothy Pederson 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 Timothy Pederson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Timothy Pederson reassigns Medicare benefits to Kaiser Foundation Health Plan Of The Northwest (Portland, OR). 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 Timothy 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 Timothy Pederson was last updated on October 18, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.
# Timothy S Pederson, MD · NPI 1154353399
Anesthesiology physician in Portland, Oregon. Individual provider, active in the CMS NPPES registry since July 7, 2006.
## Identity
- **NPI:** 1154353399 (Entity type: Individual)
- **Enumerated:** July 7, 2006
- **Primary specialty:** Anesthesiology · taxonomy 207L00000X
- **State license:** MD154531 (Oregon)
- **Sole proprietor:** No
## Practice location
- **Address:** 707 SW WASHINGTON ST, SUITE 700, Portland, OR 97205-3536
- **Phone:** (503) 299-9906 · **Fax:** (503) 225-9002
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Kaiser Foundation Health Plan Of The Northwest (NPI 1649722034, Portland, OR), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Minnesota Medical School, class of 2012
## Record status
- **NPPES last updated:** October 18, 2018
- **Other identifiers:** Medicaid 0188484 (MA); Medicaid 500644374 (OR)
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Source: [NPI Profile](https://npiprofile.com/npi/1154353399) · Data from the CMS NPPES public registry.