JOHN H PEMBERTON (M.D.) – Colon & Rectal Surgery Physician, NPI 1104803477

Colon & Rectal Surgery Physician

JOHN H PEMBERTON (M.D.) is a healthcare provider. based in Rochester, Minnesota. specializing in Colon & Rectal Surgery Physician. They hold the professional credentials M.D.. They hold a License No. 23441 (MN). The NPI Number for JOHN H PEMBERTON (M.D.) is 1104803477

Main info

Male

50 Years Of Experience

Accepts Medicare Assignment

Name

JOHN H PEMBERTON (M.D.)

NPI

1104803477

Phone

(507) 284-2511

Address

200 1ST ST SW

Enumeration Date

28 December 2005

Last Update Date

1 September 2021

Doctor Profile

Medical School Name

TULANE UNIVERSITY SCHOOL OF MEDICINE

Secondary Phone

5072842511

Graduation Year

1976 (50 years ago)

PAC ID

3779624705

Group Practice PAC ID

6507778255

Professional Enrollment ID

I20100112000722

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience69

Completeness75

Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for JOHN H PEMBERTON (M.D.)

1st Street Southwest, Rochester, Olmsted County, Minnesota, 55903, United States
ROCHESTER, MN 559050001
Phone: (507) 284-2511
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.

No Medicare enrollment or revalidation data available for this provider in our database.

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 55905)

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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: 6507778255View full group profile

Name	Specialty	State
DR. JODI M. MOORE-WEISS (OD)	-	WA
TYLER SCOTT OESTERLE (MD)	Psychiatry, Addiction Medicine	MN
RYAN ROBERT BENRUD (PA-C)	-	MN
KATHERINE MELISSA LUCAS JOSTAD (PA-C)	-	MN
JAN L KASPERBAUER (M.D.)	-	MN
EDWARD R LASKOWSKI (M.D.)	-	MN
JONATHAN M HOLMES (M.D.)	O P H T H A L M O L O G Y	MN
ROBERT J STROEBEL (M.D.)	-	MN
MARGARET J VANDROVEC (LICSW)	-	MN
DAVID W CLAYPOOL (M.D.)	-	MN

Reviews

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Frequently asked questions

What NPI should I save for JOHN H PEMBERTON (M.D.)?

Save NPI 1104803477 if you need a stable reference for JOHN H PEMBERTON (M.D.).

Does this profile mean JOHN H PEMBERTON (M.D.) is currently active?

Yes — JOHN H PEMBERTON (M.D.) appears active in the national provider directory.

What kind of provider is JOHN H PEMBERTON (M.D.)?

The page reflects Colon & Rectal Surgery Physician for JOHN H PEMBERTON (M.D.). Clinical services aligned with this taxonomy classification.

What location shows for JOHN H PEMBERTON (M.D.)?

We surface Rochester, Minnesota for JOHN H PEMBERTON (M.D.) based on available NPPES addresses.

Is JOHN H PEMBERTON (M.D.) a real provider?

This page reflects official NPPES data for NPI 1104803477. Always confirm identity and privileges with the practice and licensing boards.

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