Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

David Warren Pederson, DPM

Individual provider Podiatrist · NPI 1487668919

David Warren Pederson, DPM is a Podiatry in St Louis Park, Minnesota. Graduated from College of Podiatric Med and Surgery, Des Moines University in 1995, 31 years ago. Practices with Park Nicollet Clinic, a 1,773-clinician group and accepts Medicare assignment. Licensed in Kansas and Minnesota.

Years since qualifying
31
Trained at
College of Podiatric Med and Surgery, Des Moines University
Licensed in
KS, MN
In the registry since
2006
Specialties on file
2
What do these letters mean?
DPM — Doctor of Podiatric Medicine
A foot and ankle physician and surgeon.

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Practice location Address checks out

3900 Park Nicollet Blvd
St Louis Park, MN 55416-2503
Phone: (952) 993-3670
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Podiatrist (primary) Taxonomy 213E00000X · Licence 586 (MN)
Podiatrist Taxonomy 213E00000X · Licence 12/00327 (KS)

Record details

NPI number1487668919
Entity typeIndividual (Type 1)
GenderMale
Credentials DPM
Sole proprietorNo
NPI enumeratedJuly 28, 2006
Last updated in NPPESMarch 10, 2021
Certification dateMarch 10, 2021
Mailing address8170 33rd Ave S # Ms 21110q, Bloomington, MN 55425-4516

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPODIATRY
Medical schoolCOLLEGE OF PODIATRIC MED AND SURGERY, DES MOINES UNIVERSITY
Graduated 1995 (31 years in practice)
Group practice Park Nicollet Clinic — 1773 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations8 on file with Medicare

Other providers in St Louis Park