AMY PEDERSEN
NPI 1407466436
Nurse Practitioner - Family in Eden Prairie, MN

Q: What is Amy Pedersen's NPI number?

The NPI number for Amy Pedersen is 1407466436. It was assigned to this individual provider in the NPPES registry on August 4, 2020.

Q: What is Amy Pedersen's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Amy Pedersen was last updated on August 5, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 04, 2020PECOS EnrolledAccepts Medicare Assignment

6452 CITY WEST PKWY, EDEN PRAIRIE, MN 55344(952) 999-0333 Get Directions Write a Review

NPPES record last updated: August 5, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

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About Amy Pedersen NPPES

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

AMY PEDERSEN (NPI 1407466436) is an individual family provider in Eden Prairie, Minnesota, licensed in Minnesota (7578) and active in the NPI registry since August 2020. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1407466436

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameAMY PEDERSEN

Location Address6452 CITY WEST PKWYEden Prairie, MN 55344-3245

Mailing Address2425 Cavell Ave SSaint Louis Park, MN 55426-2317 · (612) 598-1435

Phone(952) 999-0333

Sole ProprietorNo

Medical School CMSOtherGraduated 2020

Enumeration DateAugust 4, 2020

Last NPPES UpdateAugust 5, 2020

NPPES CertifiedAugust 5, 2020

✔ NPI 1407466436 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 MN · 7578

6452 CITY WEST PKWY, Eden Prairie, MN 55344

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Amy Pedersen 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 ID9638581853

PECOS Enrollment IDI20201211002784

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 55344 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

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$98.61 typical visit price

range $18.32 – $138.04

Typical copayment $24.65 (range $4.58 – $34.51)

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.

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Other Providers at the Same Location NPPES 19

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

KRISTOFER BRISTOL CNP

Nurse Practitioner (Family)