DESMYN PEDERSEN DO
NPI 1780146696
Anesthesiology in Flagstaff, AZ

Active since April 01, 2019PECOS EnrolledAccepts Medicare Assignment
1200 N BEAVER ST, FLAGSTAFF, AZ 86001(928) 779-3366 Get Directions Write a Review

NPPES record last updated: July 1, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jul 1, 2025, Jun 19, 2025, Jul 7, 2022 and 1 more (4 updates tracked since 2019).

About Desmyn Pedersen Do NPPES

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

DESMYN PEDERSEN DO (NPI 1780146696) is an individual anesthesiology provider in Flagstaff, Arizona, licensed in Arizona (011671) and active in the NPI registry since April 2019. She is enrolled in Medicare PECOS, maintains a secondary practice location in Las Vegas, and is a graduate of Other (2021).

NPPES Registry Identity

NPI1780146696
Entity TypeIndividualFemale
Primary Taxonomy207L00000X
Provider Legal NameDESMYN PEDERSENCredential: DO
Location Address1200 N BEAVER STFlagstaff, AZ 86001-3118
Mailing Address1200 N Beaver St, Attn: Payer CredentialingFlagstaff, AZ 86001-3118 · (928) 213-6235 · Fax (928) 213-6292
Sole ProprietorNo
Medical School CMSOtherGraduated 2021
Enumeration DateApril 1, 2019
Last NPPES UpdateJuly 1, 20254 updates tracked since enumeration
NPPES CertifiedJuly 1, 2025
✔ NPI 1780146696 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologyAllopathic & Osteopathic Physicians
Taxonomy Code207L00000X
License✔ Licensed in AZ · 011671
Definition
An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery.
1200 N BEAVER ST, Flagstaff, AZ 86001

Secondary Practice Location 1

Location 12880 N Tenaya Way Fl 2Las Vegas, NV 89128-0618 · Phone (702) 962-9563

Accepted Insurance

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

Desmyn Pedersen Do 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 ID345644704
PECOS Enrollment IDI20250716000605
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.

Medicare Billing Reassignment

Medicare enrollment records show Desmyn Pedersen reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Family Medicine
1200 N. BEAVER STREET, ATTN: PAYER CREDENTIALING
Flagstaff, AZ 86001
  • Reassigned Medicare billing, Arizona enrollment
  • 552 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.

Anesthesiology
1200 N BEAVER ST
FLAGSTAFF, AZ 86001
Pediatrics (Neonatal-Perinatal Medicine)
1200 N BEAVER ST
FLAGSTAFF, AZ 86001
Nurse Anesthetist, Certified Registered
1200 N BEAVER ST
FLAGSTAFF, AZ 86001
Dietitian, Registered
1200 N BEAVER ST
FLAGSTAFF, AZ 86001
Emergency Medicine
1200 N BEAVER ST
FLAGSTAFF, AZ 86001
Audiologist
1200 N BEAVER ST, AUDIOLOGY DEPARTMENT
FLAGSTAFF, AZ 86001
Neurological Surgery
1200 N BEAVER ST
FLAGSTAFF, AZ 86001
Nurse Anesthetist, Certified Registered
1200 N BEAVER ST
FLAGSTAFF, AZ 86001

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 Desmyn Pedersen's NPI number?

The NPI number for Desmyn Pedersen is 1780146696. It was assigned to this individual provider in the NPPES registry on April 1, 2019.

Where is Desmyn Pedersen located?

Desmyn Pedersen practices at 1200 N Beaver St, Flagstaff, AZ 86001. The listed phone number is (928) 779-3366.

What is Desmyn Pedersen's specialty?

The primary specialty registered for this NPI is Anesthesiology with taxonomy code 207L00000X.

Is Desmyn Pedersen enrolled in Medicare?

Yes. Desmyn Pedersen 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 Desmyn Pedersen's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Desmyn Pedersen reassigns Medicare benefits to Northern Arizona Healthcare Corporation (Flagstaff, AZ). 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 Desmyn Pedersen's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Desmyn Pedersen accept?

Health plans from Blue Cross Blue Shield of Arizona and Cigna HealthCare of Arizona, Inc list Desmyn Pedersen as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Desmyn Pedersen was last updated on July 1, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.