DR. ANDREW DALE PEDERSEN (M.D.) – Otolaryngology Physician, NPI 1548235393

DR. ANDREW DALE PEDERSEN (M.D.) is a healthcare provider. based in Portland, Oregon. specializing in OTOLARYNGOLOGY. They hold the professional credentials M.D.. They hold a License No. MD60381043 (WA). The NPI Number for DR. ANDREW DALE PEDERSEN (M.D.) is 1548235393

Main info

Male
35 Years Of Experience
Accepts Medicare Assignment
Name
DR. ANDREW DALE PEDERSEN (M.D.)
NPI
1548235393
Phone
(503) 963-2801
Address
541 NE 20TH AVE STE 225
Enumeration Date
22 February 2006
Last Update Date
4 November 2024

Doctor Profile

Medical School Name
OREGON HEALTH SCIENCES UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
5032396673
Graduation Year
1991 (35 years ago)
PAC ID
8820007347
Group Practice PAC ID
2860390408
Professional Enrollment ID
I20060411000800
Address ID
OR972132990PO5050XHOYT302

Contacts

Secure Messaging
cc_otoc_ent_northeast_front_desk_pool12223125@oc.providencedirect.org
Secure Messaging
referringpent@orclinic.direct-ci.net
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience73
Completeness85
Years active:20State licenses:2Other namesUpdated within 12 months

182 OTOLARYNGOLOGY in OR

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Provider Addresses for DR. ANDREW DALE PEDERSEN (M.D.)

  • 541 NE 20TH AVE STE 225

    PORTLAND, OR 972322895

    Phone: (503) 963-2801

    Fax: (503) 963-2825

    Type: Mailing

  • 5050, Northeast Hoyt Street, North Tabor, Portland, Metro, Multnomah County, Oregon, 97213, United States

    SUITE 655

    PORTLAND, OR 972132991

    Phone: (503) 488-2400

    Fax: (503) 231-0121

    Type: Location

  • Cascadia Behavioral Healthcare Administrative Office, 847, Northeast 19th Avenue, Kerns, Portland, Metro, Multnomah County, Oregon, 97232, United States

    SUITE 300

    PORTLAND, OR 972322684

    Phone: (503) 963-2801

    Fax: (503) 963-2825

    Type: Mailing

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: 2006-04-11

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
I20060411000800IOtolaryngologyORTBD

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
99213Established patient office or other outpatient visit, 20-29 minutes13892$0
99203New patient office or other outpatient visit, 30-44 minutes111111$0
69210Removal of impacted ear wax2221$0
31575Diagnostic exam of voice box using a flexible endoscope1919$0
99204New patient office or other outpatient visit, 45-59 minutes1515$0
View full utilization report →

Insurance plans in this area (ZIP 97232)

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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: 2860390408View full group profile
NameSpecialtyState
Pulmonary DiseaseOR
-OR
O T O L A R Y N G O L O G YOR
Internal Medicine, GastroenterologyOR
Gastroenterology, Internal MedicineOR
-OR
-OR
Qualified AudiologistOR
Physician AssistantOR
N E U R O S U R G E R YOR

Reviews

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Frequently asked questions

Does DR. ANDREW DALE PEDERSEN (M.D.) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — DR. ANDREW DALE PEDERSEN (M.D.) uses 1548235393.
Is DR. ANDREW DALE PEDERSEN (M.D.) still practicing?
DR. ANDREW DALE PEDERSEN (M.D.) is currently listed as active in the public NPI registry.
What is DR. ANDREW DALE PEDERSEN (M.D.) best known for clinically?
Directory data describes DR. ANDREW DALE PEDERSEN (M.D.) with Otolaryngology Physician. Clinical services aligned with this taxonomy classification.
Where should I expect DR. ANDREW DALE PEDERSEN (M.D.) on a map?
Expect Portland, Oregon as a primary anchor for DR. ANDREW DALE PEDERSEN (M.D.) unless the record lists multiple sites.
Why does DR. ANDREW DALE PEDERSEN (M.D.) have multiple addresses?
3 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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