DR. JOSEPH T. PEDERSEN M.D.
NPI 1417969064
Radiology - Radiation Oncology in Pikeville, KY

NPI Status: Active since August 12, 2006

Contact Information

911 BYPASS RD
PIKEVILLE, KY
ZIP 41501
Phone: (606) 218-3500

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  • Individual
  • Male
  • Years of Experience 32
  • Radiology
  • Radiation Oncology
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About JOSEPH PEDERSEN

This page provides the complete NPI Profile along with additional information for Joseph Pedersen, a provider established in Pikeville, Kentucky with a medical specialization in Radiology, focusing in radiation oncology and more than 32 years of experience. The healthcare provider is registered in the NPI registry with number 1417969064 assigned on August 2006. The practitioner's primary taxonomy code is 2085R0001X with license number 34198 (KY). The provider is registered as an individual and his NPI record was last updated 13 years ago.

NPI
1417969064
Provider Name
DR. JOSEPH T. PEDERSEN M.D.
Gender
Male
Entity Type
Individual
Location Address
911 BYPASS RD PIKEVILLE, KY 41501
Location Phone
(606) 218-3500
Mailing Address
PO BOX 2917 PIKEVILLE, KY 41502
Mailing Phone
(606) 218-3500
Medical School Name
OTHER
Graduation Year
1994
Is Sole Proprietor?
No
Enumeration Date
08-12-2006
Last Update Date
06-11-2013
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Radiology Radiation Oncology

Taxonomy Code
2085R0001X
Type
Allopathic & Osteopathic Physicians
License No.
34198
License State
KY
Taxonomy Description
A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
12085R0001XAllopathic & Osteopathic Physicians

Radiology
Radiation Oncology

MD-067177-L (PA)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Blue Direction Bronze 1 - POS
  • Blue Direction Silver 1 - POS
  • Blue Direction Silver 1 + Adult Vision - POS
  • Blue Direction Silver 2 - POS
  • Blue Direction Standard Expanded Bronze - POS
  • Blue Direction Standard Gold - POS
  • Blue Direction Standard Silver - POS
  • Blue VirtuConnect Bronze 1 - EPO
  • Blue VirtuConnect Gold 1 - EPO
  • Blue VirtuConnect Silver 1 - EPO
  • Bronze 7500 $25 Generic Drugs - HMO
  • Bronze 7500 $25 Generic Drugs + Adult Vision & Fitness - HMO
  • Core Gold 1500 $10 Generic Drugs - HMO
  • Core Gold 1500 $10 Generic Drugs + Adult Vision & Fitness - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Gold 2000 $15 Generic Drugs - HMO
  • Gold 2000 $15 Generic Drugs + Adult Vision & Fitness - HMO
  • Molina Gold Core 1640 - HMO
  • Molina Gold Core 1640 Plus with Adult Dental and Vision - HMO
  • Molina Gold Core 1640 Plus with Adult Vision - HMO
  • Molina Gold Standard - HMO
  • Molina Gold Value - HMO
  • Molina Gold Value Plus with Adult Dental and Vision - HMO
  • Molina Gold Value Plus with Adult Vision - HMO
  • Molina Silver Core - HMO
  • Molina Silver Core Plus with Adult Dental and Vision - HMO
  • Molina Silver Core Plus with Adult Vision - HMO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals - HMO
  • UHC Bronze Standard (No Referrals) - HMO
  • UHC Bronze Standard+ Dental + Vision (No Referrals) - HMO
  • UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) - HMO
  • UHC Gold Advantage + ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) - HMO
  • UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Gold Standard (No Referrals) - HMO
  • UHC Silver Advantage ($0 Virtual Urgent Care, $3 Tier 2 Rx, No Referrals) - HMO
  • UHC Silver Advantage + ($0 Virtual Urgent Care, $3 Tier 2 Rx, Dental + Vision, No Referrals) - HMO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
001765945OTHER (01)PAHIGHMARK BLUE CROSS
096482MEDICARE ID-TYPE UNSPECIFIED (04)PA 
1013753370001MEDICAID (05)PA 
K085390MEDICARE PIN (08)KY 
H00791MEDICARE UPIN (02)PA 

Medicare Participation & PECOS Enrollment Status

Joseph Pedersen is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Joseph Pedersen is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 5890759914

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20251010004003

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $40.56 for a new patient copayment and $16.56 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 41501 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99205

  • Average New Patient Price $162.27
  • Minimum New Patient Price $52.76
  • Maximum New Patient Price $162.27
  • Average New Patient Copayment $40.56
  • Minimum New Patient Copayment $13.19
  • Maximum New Patient Copayment $40.56

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99213

  • Average Established Patient Price $66.24
  • Minimum Established Patient Price $16.53
  • Maximum Established Patient Price $131.99
  • Average Established Patient Copayment $16.56
  • Minimum Established Patient Copayment $4.13
  • Maximum Established Patient Copayment $32.99

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Reviews for DR. JOSEPH T. PEDERSEN M.D.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1417969064, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 66. The final step is to find the difference between that total and the next multiple of ten (70 - 66 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
4
Unchanged
Pos 3
1
Doubled → 2
Pos 4
7
Unchanged
Pos 5
9
Doubled → 18 → 1 + 8
Pos 6
6
Unchanged
Pos 7
9
Doubled → 18 → 1 + 8
Pos 8
0
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 9 → 18 → 9 9 → 18 → 9 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 4 + 2 + 7 + 1 + 8 + 6 + 1 + 8 + 0 + 1 + 2 + 24 = 66

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 66 is 70. The difference is the calculated check digit.

70 - 66 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1417969064.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Ambulance (Air Transport)
911 BYPASS RD
PIKEVILLE, KY 41501
Nurse Anesthetist, Certified Registered
911 BYPASS RD
PIKEVILLE, KY 41501
General Acute Care Hospital
911 BYPASS RD
PIKEVILLE, KY 41501
Neurological Surgery
911 BYPASS RD
PIKEVILLE, KY 41501
Surgery (Vascular Surgery)
911 BYPASS RD
PIKEVILLE, KY 41501
Psychologist (Clinical)
911 BYPASS RD
PIKEVILLE, KY 41501
Anesthesiology
911 BYPASS RD
PIKEVILLE, KY 41501
Anesthesiology
911 BYPASS RD
PIKEVILLE, KY 41501
Nurse Anesthetist, Certified Registered
911 BYPASS RD
PIKEVILLE, KY 41501
Nurse Anesthetist, Certified Registered
911 BYPASS RD
PIKEVILLE, KY 41501
Nurse Anesthetist, Certified Registered
911 BYPASS RD
PIKEVILLE, KY 41501
Nurse Anesthetist, Certified Registered
911 BYPASS RD
PIKEVILLE, KY 41501
Internal Medicine
911 BYPASS RD
PIKEVILLE, KY 41501
Rehabilitation Hospital
911 BYPASS RD
PIKEVILLE, KY 41501
Dietitian, Registered
911 BYPASS RD
PIKEVILLE, KY 41501
Nurse Practitioner (Family)
911 BYPASS RD
PIKEVILLE, KY 41501
Dietitian, Registered
911 BYPASS RD
PIKEVILLE, KY 41501
Early Intervention Provider Agency
911 BYPASS RD
PIKEVILLE, KY 41501
Hospitalist
911 BYPASS RD
PIKEVILLE, KY 41501
Internal Medicine
911 BYPASS RD
PIKEVILLE, KY 41501

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1417969064, enumerated as an "individual" on August 12, 2006.

The provider is located at 911 BYPASS RD PIKEVILLE, KY 41501 and the phone number is (606) 218-3500.

Radiology with taxonomy code 2085R0001X and a focus in Radiation Oncology.

The provider might be accepting Accepts: BlueCross BlueShield of South Carolina,. Please consult your insurance carrier or call the provider to verify.