ALEXANDER DAVID PEDERSON (MD) – Anatomic Pathology & Clinical Pathology Physician, NPI 1841307899
Anatomic Pathology & Clinical Pathology Physician
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
766 PATHOLOGY in IL
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Provider Addresses for ALEXANDER DAVID PEDERSON (MD)
Pop in a Box, 800, Avenida Presidente Juscelino Kubitscheck de Oliveira, Jardim Panorama, São José do Rio Preto, Região Imediata de São José do Rio Preto, Região Geográfica Intermediária de São José do Rio Preto, São Paulo, Southeast Region, 15092-450, Brazil
ORLANDO, FL 328144333
Phone: (407) 422-9831
Fax: (407) 206-1767
Type: Mailing
211, South 3rd Street, Belleville, Saint Clair County, Illinois, 62220, United States
DEPT OF PATHOLOGY
BELLEVILLE, IL 622201915
Phone: (618) 234-2120
Fax: (618) 222-4630
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $186.
Total Amount is formed as General ($186) + Research ($0) + Ownership ($0) = $186.
Last reported payment date: 2024-11-05 • Largest payer in this snapshot: Siemens Medical Solutions USA, Inc. ($145).
Total Amount
$186
General + Research + Ownership
Payments
3
Total payment records
General Amount
$186
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-05
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Siemens Medical Solutions USA, Inc. | $145 |
| AstraZeneca Pharmaceuticals LP | $41 |
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2017-12-01
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20171201001703 | I | Pathology | IA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 1,124 | 624 | $0 |
| 88341 | Special stained specimen slides to examine tissue, each additional procedure | 157 | 48 | $0 |
| 88312 | Special stained specimen slides to identify organisms including interpretation and report | 151 | 136 | $0 |
| 88112 | Cell examination of specimen, selective cellular enhancement technique | 115 | 102 | $0 |
| 88304 | Pathology examination of tissue using a microscope, moderately low complexity | 105 | 86 | $0 |
Insurance plans in this area (ZIP 32814)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| PATHOLOGY | IL | 88304 | Pathology examination of tissue using a microscope, moderately low complexity | 74 | 69 |
| PATHOLOGY | IL | 88307 | Pathology examination of tissue using a microscope, moderately high complexity | 60 | 46 |
| PATHOLOGY | IL | 88312 | Special stained specimen slides to identify organisms including interpretation and report | 215 | 183 |
| PATHOLOGY | IL | 88342 | Tissue or cell analysis by immunologic technique | 16 | 13 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | IA | |
| Diagnostic Radiology | AZ | |
| Certified Registered Nurse Anesthetist (Crna) | IA | |
| Family Practice, Hospitalist | IA | |
| Nurse Practitioner | IA | |
| Internal Medicine, Cardiovascular Disease (Cardiology) | IA | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IA | |
| Diagnostic Radiology | CT | |
| Nurse Practitioner | IA |
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