MR. TIMOTHY S PEDERSEN (MS, PT) – Physical Therapist, NPI 1114004231

MR. TIMOTHY S PEDERSEN (MS, PT) is a healthcare provider. based in Fairhaven, Massachusetts. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials MS, PT. They hold a License No. 8305 (MA). The NPI Number for MR. TIMOTHY S PEDERSEN (MS, PT) is 1114004231

Main info

Male
Sole Proprietor
36 Years Of Experience
Accepts Medicare Assignment
Name
MR. TIMOTHY S PEDERSEN (MS, PT)
NPI
1114004231
Phone
(508) 991-2918
Address
17 SARAHS WAY
Enumeration Date
1 November 2006
Last Update Date
8 September 2011

Doctor Profile

Medical School Name
OTHER
Secondary Phone
5089912918
Graduation Year
1990 (36 years ago)
PAC ID
6608918693
Group Practice PAC ID
1658535141
Professional Enrollment ID
I20100129000157
Address ID
MA027194013FA147XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience61
Completeness75
Years active:19State licenses:2Digital endpointsOther names

2,873 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MA

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Provider Addresses for MR. TIMOTHY S PEDERSEN (MS, PT)

  • 15;17, Sarahs Way, Fairhaven, Bristol County, Massachusetts, 02719, United States

    FAIRHAVEN, MA 027193161

    Phone: (508) 991-2918

    Fax: (508) 994-3068

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2010-01-29

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20100129000157IPhysical Therapist In Private PracticeMATBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes1,240149$0
97140Therapy procedure using manual technique, each 15 minutes38694$0
97530Therapy procedure using functional activities26973$0
97116Therapy procedure for walking training, each 15 minutes10232$0
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes4113$0
View full utilization report →

Insurance plans in this area (ZIP 02719)

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Provider's Procedures

MR. TIMOTHY S PEDERSEN (MS, PT) performs procedures in PHYSICAL THERAPIST IN PRIVATE PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYMA97140Manual (physical) therapy techniques to 1 or more regions, each 15 minutes14828

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1658535141View full group profile
NameSpecialtyState
-MA
Physical Therapist In Private PracticeMA
Physical Therapist In Private PracticeMA

Reviews

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Frequently asked questions

Does MR. TIMOTHY S PEDERSEN (MS, PT) have a public NPI I can cite?
Public records show MR. TIMOTHY S PEDERSEN (MS, PT) under NPI 1114004231.
Should I treat MR. TIMOTHY S PEDERSEN (MS, PT) as an active provider?
Patients and plans typically see MR. TIMOTHY S PEDERSEN (MS, PT) as active in the national extract.
What services align with MR. TIMOTHY S PEDERSEN (MS, PT)'s listing?
MR. TIMOTHY S PEDERSEN (MS, PT)'s public classification highlights Physical Therapist. Clinical services aligned with this taxonomy classification.
Which community is linked to MR. TIMOTHY S PEDERSEN (MS, PT)?
MR. TIMOTHY S PEDERSEN (MS, PT) shows a connection to Fairhaven, Massachusetts in registry-derived data.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.