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

Jacob Matthew Pederson, DO

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1932441318

Jacob Matthew Pederson, DO is an Emergency Medicine in LA Crosse, Wisconsin. Qualified in 2013, 13 years ago. Practices with Gundersen Lutheran Medical Center Inc, a 896-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
13
Licensed in
WI
In the registry since
2013
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

1836 S Ave
LA Crosse, WI 54601-5429
Phone: (608) 782-7300
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 63416 (WI)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1932441318
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedMarch 22, 2013
Last updated in NPPESJune 10, 2016
Mailing address1836 South Ave, La Crosse, WI 54601-5429

Medicare enrollment

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

Medicare specialtyEMERGENCY MEDICINE
Medical schoolOTHER
Graduated 2013 (13 years in practice)
Group practice Gundersen Lutheran Medical Center Inc — 896 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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