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DR. KATHLEEN MARIE PEDERSEN M.D.
NPI 1700221918
Pediatrics in Irving, TX

Active since May 01, 2013PECOS Enrolled
1111 W AIRPORT FWY, SUITE 143, IRVING, TX 75062(469) 488-4500 Get Directions Write a Review

NPPES record last updated: July 9, 2016. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Kathleen Marie Pedersen M.d. NPPES

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

DR. KATHLEEN MARIE PEDERSEN M.D. (NPI 1700221918) is an individual pediatrics provider in Irving, Texas, licensed in Texas (Q9000) and active in the NPI registry since May 2013. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1700221918
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameDR. KATHLEEN MARIE PEDERSENCredential: M.D.
Location Address1111 W AIRPORT FWY, SUITE 143Irving, TX 75062-6203
Mailing Address1111 W Airport Fwy, Suite 143Irving, TX 75062-6203
Phone(469) 488-4500
Sole ProprietorNo
Enumeration DateMay 1, 2013
Last NPPES UpdateJuly 9, 2016
✔ NPI 1700221918 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in TX · Q9000
Definition

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

1111 W AIRPORT FWY, Irving, TX 75062
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kathleen Marie Pedersen M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 75062 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
$88.19 typical visit price
range $57.18 – $172.86
Typical copayment $22.04 (range $14.29 – $43.21)
Most-billed visit code 99203
Established Patient
$100.80 typical visit price
range $18.48 – $141.20
Typical copayment $25.20 (range $4.62 – $35.30)
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

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

DC DENTAL ASSOCIATES OF IRVING
Clinic/Center (Dental)
1111 W AIRPORT FWY, STE 201
IRVING, TX 75062
Dallas County (972) 793-0735

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 Kathleen Pedersen's NPI number?

The NPI number for Kathleen Pedersen is 1700221918. It was assigned to this individual provider in the NPPES registry on May 1, 2013.

Where is Kathleen Pedersen located?

Kathleen Pedersen practices at 1111 W Airport Fwy Suite 143, Irving, TX 75062. The listed phone number is (469) 488-4500.

What is Kathleen Pedersen's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Kathleen Pedersen enrolled in Medicare?

Yes. Kathleen Pedersen is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kathleen Pedersen was last updated on July 9, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.