ELIZABETH PEDERSON OT
NPI 1669622411
Occupational Therapist in Appleton, WI
About Elizabeth Pederson Ot NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ELIZABETH PEDERSON OT (NPI 1669622411) is an individual occupational therapist in Appleton, Wisconsin, licensed in Wisconsin (3622) and active in the NPI registry since September 2008.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Elizabeth Pederson Ot is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Elizabeth Pederson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Kimberly, WI 54136
- Reassigned Medicare billing, Wisconsin and Minnesota enrollments
- Also billed through NPI 1033611298 (Minnesota)
- 63 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 19
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 Elizabeth Pederson's NPI number?
The NPI number for Elizabeth Pederson is 1669622411. It was assigned to this individual provider in the NPPES registry on September 29, 2008.
Where is Elizabeth Pederson located?
Elizabeth Pederson practices at 1650 Tri Park Way Suite A, Appleton, WI 54914. The listed phone number is (920) 830-6697.
What is Elizabeth Pederson's specialty?
The primary specialty registered for this NPI is Occupational Therapist with taxonomy code 225X00000X.
Is Elizabeth Pederson enrolled in Medicare?
Yes. Elizabeth Pederson is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Elizabeth Pederson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Elizabeth Pederson reassigns Medicare benefits to Aegis Group Practice LLC (Kimberly, WI). 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 Elizabeth 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 Elizabeth Pederson was last updated on September 29, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.