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

Nicholas Pedersen

Individual provider Physician Assistant · NPI 1619502275

Nicholas Pedersen is a Physician Assistant in Cumberland, Wisconsin. Qualified in 2020, 6 years ago. Practices with Cumberland Memorial Hospital Inc, an 18-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
6
Licensed in
WI
In the registry since
2020

Practice location Address checks out

1705 16th Ave
Cumberland, WI 54829-8601
Phone: (715) 822-7500
Fax: (715) 822-7501
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5071 (WI)

Record details

NPI number1619502275
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedMarch 4, 2020
Last updated in NPPESMarch 24, 2026
Certification dateMarch 24, 2026
Mailing address1705 16th Ave, Cumberland, WI 54829-8601

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Cumberland Memorial Hospital Inc — 18 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Cumberland