1. Home
  2. Directory
  3. Texas
  4. Mansfield
  5. Family Medicine
  6. NPI Profile

KATHERINE PEDERSON D.O.
NPI 1902218852
Family Medicine in Mansfield, TX

Active since May 27, 2014PECOS EnrolledAccepts Medicare Assignment
1757 BROAD PARK CIR N STE 201, MANSFIELD, TX 76063(817) 806-1130(817) 806-1133 Get Directions Write a Review

NPPES record last updated: January 24, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 6, 2023, Feb 22, 2022, Sep 5, 2018 (3 updates tracked since 2018).

About Katherine Pederson D.o. NPPES

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

KATHERINE PEDERSON D.O. (NPI 1902218852) is an individual family medicine provider in Mansfield, Texas, licensed in Texas (Q7593) and active in the NPI registry since May 2014. She is enrolled in Medicare PECOS, is affiliated with Baylor Scott & White Medical Center- Waxahachie, and is a graduate of At Still University Of Health Sciences, College Of Osteo Med, Kirksville (2014).

NPPES Registry Identity

NPI1902218852
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameKATHERINE PEDERSONCredential: D.O.
Location Address1757 BROAD PARK CIR N STE 201Mansfield, TX 76063-7839
Mailing AddressPo Box 6278Fort Worth, TX 76115-0278 · (817) 568-5467 · Fax (817) 568-5474
Phone(817) 806-1130
Fax(817) 806-1133
Sole ProprietorNo
Medical School CMSAt Still University Of Health Sciences, College Of Osteo Med, KirksvilleGraduated 2014
Enumeration DateMay 27, 2014
Last NPPES UpdateJanuary 24, 20243 updates tracked since enumeration
NPPES CertifiedJanuary 24, 2024
✔ NPI 1902218852 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in TX · Q7593
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
1757 BROAD PARK CIR N STE 201, Mansfield, TX 76063
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.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

Katherine Pederson D.o. 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 ID547551004
PECOS Enrollment IDI20161003000109
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.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
128 services48 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
52 services39 patients
Osteopathic manipulative treatment, 9-10 body regions 98929
Osteopathic Manipulative Treatment (OMT) involves hands-on care. In a 9-10 body regions procedure, a doctor manipulates muscles and joints using techniques like stretching, gentle pressure, and resistance to improve health and wellness. It's often used to ease pain, promote healing, and increase overall mobility.
41 services12 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
34 services34 patients
Annual depression screening, 5 to 15 minutes G0444
An annual depression screening is a short, routine evaluation to check for signs of depression. It involves answering a series of questions about your feelings, thoughts, and behaviors. The process takes about 15 minutes and helps detect depression early for better management.
28 services28 patients
New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
19 services19 patients

Hospital Affiliations CMS Care Compare 4

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Baylor Scott & White Medical Center- Waxahachie

Acute Care Hospitals · Waxahachie, TX
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number450372
Location2400 N Interstate Highway 35EWaxahachie, TX 75165 · Ellis County
Emergency services Birthing friendly

Methodist Mansfield Medical Center

Acute Care Hospitals · Mansfield, TX
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number670023
Location2700 E Broad StreetMansfield, TX 76063 · Tarrant County
Emergency services Birthing friendly

Methodist Midlothian Medical Center

Acute Care Hospitals · Midlothian, TX
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number670300
Location1201 E Highway 287Midlothian, TX 76065 · Ellis County
Emergency services Birthing friendly

Texas Health Hospital Mansfield

Acute Care Hospitals · Mansfield, TX
3/5 CMS rating
OwnershipProprietary
CMS Certification Number670309
Location2300 Lone Star RoadMansfield, TX 76063 · Tarrant County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 76063 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
$87.20 typical visit price
range $56.47 – $171.07
Typical copayment $21.80 (range $14.11 – $42.76)
Most-billed visit code 99203
Established Patient
$99.68 typical visit price
range $18.18 – $139.68
Typical copayment $24.92 (range $4.54 – $34.92)
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 2

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

MRS. ANDREA ANDERSON FNP-BC
Nurse Practitioner (Family)
1757 BROAD PARK CIR N STE 201
MANSFIELD, TX 76063
Tarrant County (817) 806-1130
GARRICK M SMITHERMAN
Nurse Practitioner (Family)
1757 BROAD PARK CIR N STE 201
MANSFIELD, TX 76063
Tarrant County (817) 806-1130

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 Katherine Pederson's NPI number?

The NPI number for Katherine Pederson is 1902218852. It was assigned to this individual provider in the NPPES registry on May 27, 2014.

Where is Katherine Pederson located?

Katherine Pederson practices at 1757 Broad Park Cir N Ste 201, Mansfield, TX 76063. The listed phone number is (817) 806-1130.

What is Katherine Pederson's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Katherine Pederson enrolled in Medicare?

Yes. Katherine Pederson 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.

What insurance does Katherine Pederson accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma and 8 other insurers list Katherine Pederson 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.

Is Katherine Pederson affiliated with any hospitals?

According to CMS data, Katherine Pederson is affiliated with Baylor Scott & White Medical Center- Waxahachie, Methodist Mansfield Medical Center, Methodist Midlothian Medical Center and Texas Health Hospital Mansfield.

When was this NPI record last updated?

The NPPES record for Katherine Pederson was last updated on January 24, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.