Jerry R. Pederson, O.D., P.C.
NPI 1073742938 · Optometrist · Centennial, CO
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Jerry R. Pederson, O.D., P.C. is a Optometrist organization in Centennial, CO (NPI 1073742938).
Provider details
- NPI number
- 1073742938
- Entity type
- Organization
- Primary specialty
- OptometristEye and Vision Services Providers
- Organization subpart
- No
- Authorized official
- Jon Pederson, Owner(303) 798-5533
Specialties & taxonomies
Eye and Vision Services Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
16 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Southglenn Eyecare, PC
- Doing business as
- Southglenn Eyecare, PC
Registry dates
- Enumerated
- 2009-07-13
- Last updated
- 2020-09-15
- Certified
- 2020-09-15
Frequently asked questions
- What is Jerry R. Pederson, O.D., P.C.'s NPI number?
- Jerry R. Pederson, O.D., P.C.'s National Provider Identifier (NPI) is 1073742938, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Jerry R. Pederson, O.D., P.C.?
- Jerry R. Pederson, O.D., P.C. is classified in the NPPES registry as Optometrist (Eye and Vision Services Providers).
- Where is Jerry R. Pederson, O.D., P.C. located?
- Jerry R. Pederson, O.D., P.C.'s practice location on file with NPPES is 6650 S Vine St, Centennial, CO 80121-2769.
- What is Jerry R. Pederson, O.D., P.C.'s phone number?
- The practice phone number listed in the NPPES registry for Jerry R. Pederson, O.D., P.C. is (303) 798-5533.
- Does Jerry R. Pederson, O.D., P.C. accept Medicare?
- Jerry R. Pederson, O.D., P.C. is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Jerry R. Pederson, O.D., P.C.?
- The authorized official listed on Jerry R. Pederson, O.D., P.C.'s NPPES record is Jon Pederson, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Jerry R. Pederson, O.D., P.C.'s NPI active?
- Yes — Jerry R. Pederson, O.D., P.C.'s NPI (1073742938) is active in the NPPES registry as of the last update on 2020-09-15.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.