MRS. JENNIFER BLOEDEL PEDERSON (P.T.) – Physical Therapist, NPI 1265556310

MRS. JENNIFER BLOEDEL PEDERSON (P.T.) is a healthcare provider. based in Edina, Minnesota. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials P.T.. They hold a License No. 6794 (MN). The NPI Number for MRS. JENNIFER BLOEDEL PEDERSON (P.T.) is 1265556310

Main info

Female
25 Years Of Experience
Accepts Medicare Assignment
Name
MRS. JENNIFER BLOEDEL PEDERSON (P.T.)
NPI
1265556310
Phone
(952) 935-5886
Address
6017 PINE GROVE RD
Enumeration Date
16 March 2007
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8665253175
Graduation Year
2001 (25 years ago)
PAC ID
5092209130
Group Practice PAC ID
6103230172
Professional Enrollment ID
I20251216000910
Address ID
MN551012666SA428XXSTXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

2,108 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MN

Provider Addresses for MRS. JENNIFER BLOEDEL PEDERSON (P.T.)

  • 6017 PINE GROVE RD

    EDINA, MN 554361236

    Phone: (952) 935-5886

    Type: Mailing

  • 1284 CORPORATE CENTER DR

    SUITE 500

    EAGAN, MN 551211253

    Phone: (651) 686-0098

    Type: Location

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: 2025-12-16

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
I20251216000910IPhysical Therapist In Private PracticeMNTBD

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.

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

Insurance plans in this area (ZIP 55436)

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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: 6103230172View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeMN
Physical Therapist In Private PracticeMN
Physical Therapist In Private PracticeMN
Physical Therapist In Private PracticeMN
Physical Therapist In Private PracticeMN
Physical Therapist In Private PracticeMN
Physical Therapist In Private PracticeNY
Physical Therapist In Private PracticeMN
Physical Therapist In Private PracticeMN
Physical Therapist In Private PracticeAZ

Reviews

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Frequently asked questions

Is MRS. JENNIFER BLOEDEL PEDERSON (P.T.) listed with a National Provider Identifier?
Yes — MRS. JENNIFER BLOEDEL PEDERSON (P.T.) has NPI 1265556310 on file in the registry.
Is MRS. JENNIFER BLOEDEL PEDERSON (P.T.) still an active registrant?
MRS. JENNIFER BLOEDEL PEDERSON (P.T.) carries an active NPI according to the public dataset.
What kind of doctor is MRS. JENNIFER BLOEDEL PEDERSON (P.T.)?
MRS. JENNIFER BLOEDEL PEDERSON (P.T.) is associated with Physical Therapist in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with MRS. JENNIFER BLOEDEL PEDERSON (P.T.)?
Directory geography for MRS. JENNIFER BLOEDEL PEDERSON (P.T.) centers on Edina, Minnesota.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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