TRACY PEDERSON – Clinical Social Worker, NPI 1144897604

TRACY PEDERSON is a healthcare provider. based in Sun prairie, Wisconsin. specializing in CLINICAL SOCIAL WORKER. They hold a License No. 8875-123 (WI). The NPI Number for TRACY PEDERSON is 1144897604

Main info

Female
16 Years Of Experience
Name
TRACY PEDERSON
NPI
1144897604
Phone
(608) 318-0086
Address
865 WILLOW BROOK TRL
Enumeration Date
4 June 2021
Last Update Date
4 June 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6082444859
Graduation Year
2010 (16 years ago)
PAC ID
8022407436
Group Practice PAC ID
6608264742
Professional Enrollment ID
I20211104003207
Address ID
WI537045314MA1943XSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

1,447 CLINICAL SOCIAL WORKER in WI

Provider Addresses for TRACY PEDERSON

  • 865 WILLOW BROOK TRL

    SUN PRAIRIE, WI 535903454

    Phone: (608) 318-0086

    Type: Mailing

  • 2021 ATWOOD AVE

    MADISON, WI 537045324

    Phone: (608) 244-4859

    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: 2021-11-04

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
I20211104003207IClinical Social WorkerWITBD

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 53590)

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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: 6608264742View full group profile
NameSpecialtyState
Marriage And Family TherapistWI
Mental Health CounselorWI
Mental Health CounselorWI
Clinical PsychologistWI
Marriage And Family TherapistWI
Clinical Social WorkerWI
Mental Health CounselorWI
Mental Health CounselorWI
Mental Health CounselorWI
Clinical Social WorkerWI

Reviews

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Frequently asked questions

Can I verify TRACY PEDERSON with an NPI only?
You can start verification with NPI 1144897604 for TRACY PEDERSON, then check state licensing separately.
Does CMS list TRACY PEDERSON as active?
Yes — TRACY PEDERSON is active in the NPI listing used on this page.
What is TRACY PEDERSON best known for clinically?
Directory data describes TRACY PEDERSON with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What area does TRACY PEDERSON serve?
TRACY PEDERSON's listing highlights Sun Prairie, Wisconsin; more addresses can appear in NPPES.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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