JACOB MATTHEW PEDERSON D.O.
NPI 1932441318
Emergency Medicine in La Crosse, WI

NPI Status: Active since March 22, 2013

Contact Information

1836 SOUTH AVE
LA CROSSE, WI
ZIP 54601
Phone: (608) 782-7300

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  • Individual
  • Male
  • Years of Experience 13
  • Emergency Medicine
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About JACOB PEDERSON

This page provides the complete NPI Profile along with additional information for Jacob Pederson, a provider established in La Crosse, Wisconsin with a medical specialization in Emergency Medicine and more than 13 years of experience. The healthcare provider is registered in the NPI registry with number 1932441318 assigned on March 2013. The practitioner's primary taxonomy code is 207P00000X with license number 63416 (WI). The provider is registered as an individual and his NPI record was last updated 9 years ago.

NPI
1932441318
Provider Name
JACOB MATTHEW PEDERSON D.O.
Gender
Male
Entity Type
Individual
Location Address
1836 SOUTH AVE LA CROSSE, WI 54601
Location Phone
(608) 782-7300
Mailing Address
1836 SOUTH AVE LA CROSSE, WI 54601
Mailing Phone
(608) 782-7300
Medical School Name
OTHER
Graduation Year
2013
Is Sole Proprietor?
No
Enumeration Date
03-22-2013
Last Update Date
06-10-2016
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Emergency Medicine

Taxonomy Code
207P00000X
Type
Allopathic & Osteopathic Physicians
License No.
63416
License State
WI
Taxonomy Description
An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1390200000XStudent, Health Care

Student in an Organized Health Care Education/Training Program

 

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Anthem Bronze Preferred/Broad 5000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
  • Anthem Bronze Preferred/Broad HSA (+ Incentives) - POS
  • Anthem Bronze Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Preferred/Broad 1000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Gold Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Anthem Heart Healthy Bronze Preferred/Broad 0 Med Ded ($0 Virtual PCP+$0 Select Drugs+Incentives) - POS
  • Anthem Silver Preferred/Broad 4000 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
  • Anthem Silver Preferred/Broad 5300 (3 Free PCP Visits + $0 Select Drugs + Incentives) - POS
  • Anthem Silver Preferred/Broad Standard ($0 Virtual PCP + $0 Select Drugs + Incentives) - POS
  • Partners HMO Bronze 5000 Ded/9200 MOOP - HMO
  • Partners HMO Bronze 7500 Ded/9200 MOOP - HMO
  • Partners HMO Bronze 7900 Ded/7900 MOOP HSA - HMO
  • Partners HMO Gold 1000 Ded/6000 MOOP with Vision - HMO
  • Partners HMO Gold 1500 Ded/7800 MOOP - HMO
  • Partners HMO Gold 2900 Ded/2900 MOOP HSA - HMO
  • Partners HMO Silver 4100 Ded/7500 MOOP with Vision - HMO
  • Partners HMO Silver 5000 Ded/8000 MOOP - HMO
  • Partners HMO Silver 5500 Ded/5500 MOOP HSA - HMO
  • Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
  • Medica Individual Choice Bronze HSA - EPO
  • Medica Individual Choice Bronze Share - EPO
  • Medica Individual Choice Bronze Share - HMO
  • Medica Individual Choice Expanded Bronze Standard - EPO
  • Medica Individual Choice Expanded Bronze Standard - HMO
  • Medica Individual Choice Gold $0 Copay PCP Visits - EPO
  • Medica Individual Choice Gold $0 Copay PCP Visits - HMO
  • Medica Individual Choice Gold Share - EPO
  • Medica Individual Choice Gold Share - HMO
  • Medica Individual Choice Gold Standard - EPO
  • Medica Individual Choice Gold Standard - HMO
  • Medica Individual Choice Silver $0 Copay PCP Visits - EPO
  • Medica Individual Choice Silver $0 Copay PCP Visits - HMO
  • Medica Individual Choice Silver Share - EPO
  • Medica Individual Choice Silver Share - HMO
  • Medica Individual Choice Silver Standard - EPO
  • Medica Individual Choice Silver Standard - HMO
  • Medica Insure Bronze $0 Copay PCP Visits - EPO
  • Medica Insure Bronze Premier - EPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Jacob Pederson is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Jacob Pederson is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 3577857184

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20160804001087

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Emergency department visit for life threatening or functioning severity

An emergency department visit for severe conditions is when you urgently seek medical help due to serious health issues. These could be severe injuries, breathing problems, unbearable pain, or sudden severe illness. Doctors and nurses will provide immediate care to stabilize your condition.

This service was performed 107 times for 105 patients

Emergency department visit for problem of high severity

An emergency department visit for a high-severity issue means you're experiencing a serious health problem that needs immediate attention. This could be a severe injury, serious illness, or life-threatening condition. Medical professionals will provide urgent care to stabilize your condition.

This service was performed 89 times for 86 patients

Emergency department visit for problem of moderate severity

An emergency department visit for a problem of moderate severity involves immediate medical attention for issues like minor fractures, burns, or high fever. The healthcare team will assess your condition, provide necessary treatment, and may suggest further tests or admission if required.

This service was performed 15 times for 15 patients

Established patient office or other outpatient visit, 20-29 minutes

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

This service was performed 22 times for 22 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $20.73 for a new patient copayment and $23.85 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 54601 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $82.92
  • Minimum New Patient Price $53.9
  • Maximum New Patient Price $163.24
  • Average New Patient Copayment $20.73
  • Minimum New Patient Copayment $13.47
  • Maximum New Patient Copayment $40.81

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $95.41
  • Minimum Established Patient Price $17.4
  • Maximum Established Patient Price $133.76
  • Average Established Patient Copayment $23.85
  • Minimum Established Patient Copayment $4.35
  • Maximum Established Patient Copayment $33.44

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Jacob Pederson is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
GUNDERSEN LUTHERAN MEDICAL CENTER1910 SOUTH AVE
LA CROSSE, WI 54601
(608) 782-7300Acute Care Hospitals
TOMAH MEMORIAL HOSPITAL501 GOPHER DR
TOMAH, WI 54660
(608) 372-2181Critical Access Hospitals

Reviews for JACOB MATTHEW PEDERSON D.O.

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NPI Validation Check Digit Calculation


The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.

Start with the original NPI number, the last digit is the check digit and is not used in the calculation.
1932441318
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
296284232
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 9 + 6 + 2 + 8 + 4 + 2 + 3 + 2 + 24 = 62
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
70 - 62 = 88

The NPI number 1932441318 is valid because the calculated check digit 8 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 20 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1992708762 MICHAEL H MADER MD
Individual
Obstetrics & Gynecology1836 SOUTH AVE
LA CROSSE, WI 54601
(608) 782-7300
1114920709 RICHARD J MARCHIANDO DO
Individual
Orthopaedic Surgery1836 SOUTH AVE
LA CROSSE, WI 54601
(608) 782-7300
1831192111 JACQUELINE A ADSIT APNP
Individual
Nurse Practitioner1836 SOUTH AVE
LA CROSSE, WI 54601
(608) 782-7300
1730182080 RENUKA R AILIANI MD
Individual
Obstetrics & Gynecology1836 SOUTH AVE
LA CROSSE, WI 54601
(608) 782-7300
1689676900 DAVID G MUSGJERD MD
Individual
Radiology (Diagnostic Radiology)1836 SOUTH AVE
LA CROSSE, WI 54601
(608) 782-7300
1780686097 MARY E NELSON MD
Individual
Radiology (Diagnostic Radiology)1836 SOUTH AVE
LA CROSSE, WI 54601
(608) 782-7300
1356343636 JUDSON F OMANS MD
Individual
Emergency Medicine (Emergency Medical Services)1836 SOUTH AVE
LA CROSSE, WI 54601
(608) 782-7300
1700888922 ARNOLD A ASP MD
Individual
Internal Medicine (Endocrinology, Diabetes & Metabolism)1836 SOUTH AVE
LA CROSSE, WI 54601
(608) 782-7300
1235131517 DAVID D NORENBERG MD
Individual
Internal Medicine1836 SOUTH AVE
LA CROSSE, WI 54601
(608) 782-7300
1477555605 NELLEEN G NOACK MD
Individual
Pediatrics (Neurodevelopmental Disabilities)1836 SOUTH AVE
LA CROSSE, WI 54601
(608) 782-7300
1922000199 ROBERT R BABLITCH MSW
Individual
Social Worker (Clinical)1836 SOUTH AVE
LA CROSSE, WI 54601
(608) 782-7300
1386646446 LEAH A REIMANN MD
Individual
Pediatrics1836 SOUTH AVE
LA CROSSE, WI 54601
(608) 782-7300
1033111091 CAMERON F ROBERTS MD
Individual
Radiology (Diagnostic Radiology)1836 SOUTH AVE
LA CROSSE, WI 54601
(608) 782-7300
1093717050 RICHARD H REYNERTSON MD
Individual
Internal Medicine (Endocrinology, Diabetes & Metabolism)1836 SOUTH AVE
LA CROSSE, WI 54601
(608) 782-7300
1922002914 MARLENE A BANNEN PHD
Individual
Psychologist (Cognitive & Behavioral)1836 SOUTH AVE
LA CROSSE, WI 54601
(608) 782-7300
1932103900 P MICHAEL BANASIK DDS
Individual
Dentist (Oral and Maxillofacial Surgery)1836 SOUTH AVE
LA CROSSE, WI 54601
(608) 782-7300
1568466407 SUE A BEIER-HANRATTY MD
Individual
Radiology (Diagnostic Radiology)1836 SOUTH AVE
LA CROSSE, WI 54601
(608) 782-7300
1962406710 THOMAS R TERHORST MD
Individual
Radiology (Diagnostic Radiology)1836 SOUTH AVE
LA CROSSE, WI 54601
(608) 782-7300
1497759245 JAMES W TERMAN MD
Individual
Internal Medicine1836 SOUTH AVE
LA CROSSE, WI 54601
(608) 782-7300
1124022926 HUMBERT G SULLIVAN MD
Individual
Neurological Surgery1836 SOUTH AVE
LA CROSSE, WI 54601
(608) 782-7300

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1932441318, enumerated in the NPI registry as an "individual" on March 22, 2013

The provider is located at 1836 South Ave La Crosse, Wi 54601 and the phone number is (608) 782-7300

The provider's speciality is Emergency Medicine with taxonomy code 207P00000X

The provider has more than 13 years of experience.

The provider might be accepting Accepts: Anthem Blue Cross and Blue Shield, Group Health. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

Medicare beneficiaries should expect a typical cost of $82.92 with an average copayment of $20.73 for new patient appointments. Established patients should expect a typical charge of $95.41 and an average copayment of 23.85. Please review your insurance plan or contact the provider directly to determine your specific costs.

The most common procedures or services performed by this practitioner are: Emergency department visit for life threatening or functioning severity, Emergency department visit for problem of high severity, Emergency department visit for problem of moderate severity and Established patient office or other outpatient visit, 20-29 minutes.

The practitioner is affiliated to the following hospital(s): GUNDERSEN LUTHERAN MEDICAL CENTER and TOMAH MEMORIAL HOSPITAL. Hospital affiliations are identified through self-reporting data and service claims based on the place of service.

This NPI record was last updated on March 22, 2013. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.