DAVID WARREN PEDERSON (DPM) – Podiatrist, NPI 1487668919
Podiatrist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
232 PODIATRY in MN
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Provider Addresses for DAVID WARREN PEDERSON (DPM)
8170 33RD AVE S # MS 21110Q
BLOOMINGTON, MN 554254516
Phone:
Type: Mailing
3800, Park Nicollet Boulevard, Elmwood, Saint Louis Park, Hennepin County, Minnesota, 55416, United States
CREDENTIALING
ST LOUIS PARK, MN 554162527
Phone:
Type: Mailing
3900, Park Nicollet Boulevard, Elmwood, Saint Louis Park, Hennepin County, Minnesota, 55416:55424, United States
ST LOUIS PARK, MN 554162503
Phone: (952) 993-3670
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $272.
Total Amount is formed as General ($272) + Research ($0) + Ownership ($0) = $272.
Last reported payment date: 2024-05-02 • Largest payer in this snapshot: Stryker Corporation ($272).
Total Amount
$272
General + Research + Ownership
Payments
4
Total payment records
General Amount
$272
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-05-02
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Stryker Corporation | $272 |
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: 2006-09-28
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 |
|---|---|---|---|---|
| I20060928000165 | I | Podiatry | MN | 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 |
|---|---|---|---|---|
| J1100 | Injection, dexamethasone sodium phosphate, 1 mg | 312 | 50 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 135 | 135 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 115 | 93 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 110 | 86 | $0 |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 68 | 45 | $0 |
Insurance plans in this area (ZIP 55425)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| O B S T E T R I C S/ G Y N E C O L O G Y | MN | |
| Family Practice | MN | |
| - | MN | |
| Pulmonary Disease, Critical Care (Intensivists), Internal Medicine | MN | |
| Cardiac Electrophysiology | MN | |
| Family Practice | MN | |
| Physician Assistant | MN | |
| Physical Therapist In Private Practice | MN | |
| Physician Assistant | MN | |
| D E R M A T O L O G Y | MN |
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