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Nicholas Pedersen

Physician Assistant • Cumberland, WI

Active NPI 1619502275 Individual Practitioner Male Practitioner Accepts Medicare assignment
Practice location in NPPES

1705 16th Ave
Cumberland, WI 548298601

Call 7158227500 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

1705 16th Ave

Cumberland, WI 548298601

Telephone 7158227500
Fax 7158227501
Organization at the Same NPPES Address or Phone

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

CMS Doctors and Clinicians lists 1 group name: Cumberland Memorial Hospital Inc. See the list

Source: CMS Doctors and Clinicians National Downloadable File, release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Medicare Profile & Education

Source: CMS Doctors and Clinicians National Downloadable File

Graduation Year

2020

30-day fills

72 standardized 30-day fills in 2024

CMS converts prescriptions to 30-day supplies so they can be compared. A 90-day prescription counts as about three 30-day fills.

What this does not show: 30-day fills

It is not a count of patients and not a measure of quality.

Part D drug cost

$231 in 2024

The total cost of these prescriptions in 2024, paid by Medicare drug plans, patients and other payers together.

What this does not show: Part D drug cost

A higher cost often reflects the type of medicines a specialty uses. It is not your out-of-pocket cost and not a measure of quality.

Source: CMS, Medicare Part D Prescribers – by Provider and Drug, 2024.

Industry payments (Open Payments)

Fewer than 11 payment records totaling $13.62 in 2022

Drug and medical device companies must report certain payments to doctors and some other clinicians to CMS, such as meals, travel, speaking fees or research funding.

These records are submitted by drug and medical device companies, and a reported payment does not necessarily mean the financial relationship is improper.

General: payments not tied to research, such as meals, travel, consulting or speaking fees.

A reported payment does not necessarily mean the financial relationship is improper. Research payments can go to a hospital or university for a study the clinician leads, not to the clinician personally. Clinicians can dispute records with the company that reported them.

Source: CMS Open Payments, program year 2022.

Guide: How to read an Open Payments record

Years since graduation

6 years (graduated 2020)

CMS Doctors and Clinicians data list 2020 as the year this clinician finished professional school.

What this does not show: Years since graduation

It is not the number of years in practice, and more years does not mean better care.

Source: CMS Doctors and Clinicians National Downloadable File.

NPI first issued

2020

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Accepts Medicare assignment

CMS data list this clinician as accepting Medicare assignment. This means agreeing to take the Medicare-approved amount as full payment for covered services.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, “Does your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Nicholas Pedersen has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Nicholas Pedersen as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Cumberland and Wisconsin

Billing and prescribing volume is not a quality rating.

Medicare Part D prescriptions

Fewer Part D prescriptions than 70% of clinicians listed under Physician Assistant in Wisconsin (2024, 2,083 clinicians with data). Median for this group: 195. Middle half: 67 to 674.

Too few clinicians listed under Physician Assistant in Cumberland have Medicare Part D data for 2024 to compare.

Part D drug cost

A lower Part D drug cost than 85% of clinicians listed under Physician Assistant in Wisconsin (2024, 2,083 clinicians with data). Median for this group: $2,439. Middle half: $549 to $63,260.

Too few clinicians listed under Physician Assistant in Cumberland have Medicare Part D data for 2024 to compare.

2 active clinicians are listed under Physician Assistant with a practice address in Cumberland, WI (3,476 in Wisconsin).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Medicare Part D Prescribers (2024), CMS Open Payments (2022), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo · Report an error.

Pharma & Medical Device Financial Disclosures

Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments

Open Payments · Program Year 2022
Disclosure Year:

Program year 2022 (payments made January 1 – December 31, 2022): fewer than 11 records totaling $13.62.

Manufacturer Payment Nature Product Type Amount ($)
Organogenesis Inc.
Food and Beverage
Cash or cash equivalent
Puraply General $13.62

Source: CMS Open Payments, program year 2022, released June 30, 2026.

Medicare Part D Prescribing Profile & Medications

Medicare Part D prescriptions filled, including refills, in 2024.

CMS Part D · Data Year 2024
Prescription Year:
Brand Name Generic Name Prescriptions Day Supply Total Cost Patients
Hydrocodone-Acetaminophen Hydrocodone/Acetaminophen 22 55 $39.45 21
Oxycodone Hcl Oxycodone Hcl 14 48 $50.18 14
Prednisone Prednisone 12 98 $20.68 11
Tramadol Hcl Tramadol Hcl 12 41 $16.15 12
Ondansetron Odt Ondansetron 12 86 $104.78 12

Source: CMS Part D by Provider and Drug, 2024; rows below 11 claims omitted by CMS; volume isn’t quality. Privacy limits

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2026-03-24
Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

License # reported to NPPES WI 5071

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Wisconsin Department of Safety and Professional Services.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - PHYSICIAN ASSISTANT

Medicare Enrollment ID

I20200716000375

Enrollment State Jurisdiction

WI

PECOS Control ID

0446674097

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Medicare Group Practice Enrollments

Source: CMS Doctors and Clinicians National Downloadable File

Cumberland Memorial Hospital Inc

1705 16th Ave, Cumberland, WI 548298601

Phone: 7158227222

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

12 listed
Lisa Erickson , APNP

Nurse Practitioner - Family

NPI 1487174157

Advanced Practice Nurse Prescriber

Tessa Feeney , APNP

Nurse Practitioner

NPI 1235896325

Advanced Practice Nurse Prescriber

Nicole Huber , PA-C

Physician Assistant

NPI 1437472685

Physician Assistant (Certified)

Jay Jevne , PMHNP

Nurse Practitioner - Psychiatric/Mental Health

NPI 1942849484

Psychiatric-Mental Health Nurse Practitioner

Jessie Mcburney , CRNA

Nurse Anesthetist, Certified Registered

NPI 1518551431

Certified Registered Nurse Anesthetist

Dr. Tyler Miller , MD

Family Medicine

NPI 1760830707

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

10 Historical Events
📍
Updated Practice Location March 24, 2026

Registered at 1705 16TH AVE, CUMBERLAND, WI 548298601 (Tel: 7158227500)

📍
Updated Business Mailing Address March 24, 2026

Registered at 1705 16TH AVE, CUMBERLAND, WI 548298601 (Tel: 7158227500)

📍
Updated Business Mailing Address June 17, 2020

Registered at 1110 7TH AVE, CUMBERLAND, WI 548299138

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 17, 2020

Physician Assistant (license number reported to NPPES: WI 5071)

✅
NPI Profile Active March 04, 2020

NPI status registered as active in NPPES database

📍
Practice Location (Initial Record) March 04, 2020

Registered at 1110 7TH AVE, CUMBERLAND, WI 548299138 (Tel: 7158227500)

📍
Business Mailing Address (Initial Record) March 04, 2020

Registered at 750 HIGHLAND AVE, MADISON, WI 537052221

👤
Provider Name / Credentials (Initial Record) March 04, 2020

Recorded as NICHOLAS PEDERSEN

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 04, 2020

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration March 04, 2020

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1619502275
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 04, 2020
Last Update: March 24, 2026
Sole Proprietor: Yes

Mailing Address

1705 16th Ave

Cumberland, WI 548298601

Phone: 7158227500

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.