Active NPI 1780671909 Individual Practitioner Male Practitioner

Dr. Walter Jm Pedersen , MD

Specialist • St. Croix, VI

Professional Overview & Biography Verified Profile Summary

Dr. Walter Pedersen, MD is a registered healthcare professional specializing in Specialist in St. Croix, VI. Practice services are available at SUNNY ISLE PROFESSIONAL BUILDING under active NPI credentials.

Frequently performed procedures and clinical services include established patient outpatient office visit, new patient outpatient office visit, x-ray of shoulder, minimum of 2 views. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

Sunny Isle Professional Building
Suite 3-F

St. Croix, VI 008204423

Telephone 3407786110

Fax 3407782919

Associated Practice Facility / Clinic

🏢 Walter J M Pedersen Jr Md Pc Facility NPI 1184808065

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in St. Croix, VI

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.5 Yrs

State Avg: 34.5 Yrs

Regional Practice Density

1 Specialists

Practicing in St. Croix, VI (12 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

15.0% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2022)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	140	83	$90.97	$88.99
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	88	70	$126.40	$125.31
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	42	42	$168.95	$163.82
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	33	33	$114.63	$110.37
73030 X-ray of shoulder, minimum of 2 views	31	25	$43.65	$9.55
73564 X-ray of knee, 4 or more views	16	14	$54.31	$11.01

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	182	105	$93.62	$92.70
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	95	79	$132.99	$131.44
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	62	62	$115.99	$114.10
73030 X-ray of shoulder, minimum of 2 views	35	26	$43.09	$10.44
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	31	31	$170.39	$170.39
73564 X-ray of knee, 4 or more views	29	21	$55.10	$12.43
73610 X-ray of ankle, minimum of 3 views	13	11	$39.23	$10.96
73502 X-ray of hip, 2-3 views	13	13	$67.62	$11.19
73521 X-ray of both hips, 2 views	11	11	$76.39	$14.00
72100 X-ray of lower and sacral spine, 2-3 views	11	11	$50.09	$11.19

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	462	230	$76.84	$76.11
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	161	137	$110.75	$110.30
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	118	118	$112.68	$109.42
73564 X-ray of knee, 4 or more views	49	44	$56.02	$11.54
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	49	49	$167.48	$166.68
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	45	12	$10.02	$7.14
73030 X-ray of shoulder, minimum of 2 views	45	37	$42.32	$10.24
73610 X-ray of ankle, minimum of 3 views	35	25	$37.90	$9.00
73630 X-ray of foot, minimum of 3 views	33	24	$48.59	$9.39
72100 X-ray of lower and sacral spine, 2-3 views	28	28	$48.61	$11.53
73110 X-ray of wrist, minimum of 3 views	27	18	$37.59	$10.03
73521 X-ray of both hips, 2 views	27	25	$68.79	$11.52
73130 X-ray of hand, minimum of 3 views	24	16	$41.38	$8.99
20610 Aspiration and/or injection of fluid from large joint	21	13	$320.15	$65.23
99221 Initial hospital inpatient care per day, typically 30 minutes	18	18	$111.62	$103.64
73502 X-ray of hip, 2-3 views	13	12	$66.69	$11.51
72110 X-ray of lower and sacral spine, minimum of 4 views	11	11	$73.82	$13.36

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	458	226	$76.71	$74.22
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	141	117	$112.93	$109.09
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	86	86	$110.24	$108.68
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	80	80	$169.02	$163.54
73030 X-ray of shoulder, minimum of 2 views	59	55	$40.21	$10.59
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	48	17	$10.02	$6.78
73521 X-ray of both hips, 2 views	40	38	$61.64	$11.39
73630 X-ray of foot, minimum of 3 views	36	27	$46.89	$8.53
72100 X-ray of lower and sacral spine, 2-3 views	34	34	$48.20	$11.38
73564 X-ray of knee, 4 or more views	33	31	$48.01	$15.07
20610 Aspiration and/or injection of fluid from large joint	32	22	$293.65	$66.53
73110 X-ray of wrist, minimum of 3 views	22	16	$36.78	$8.63
73130 X-ray of hand, minimum of 3 views	18	12	$40.81	$10.25
A4565 Slings	13	12	$22.60	$8.73
73562 X-ray of knee, 3 views	12	11	$37.54	$12.79

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	386	202	$74.50	$71.13
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	149	120	$110.20	$105.14
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	131	131	$167.65	$160.84
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	58	21	$9.85	$7.11
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	42	42	$110.02	$105.52
20610 Aspiration and/or injection of fluid from large joint	38	27	$393.64	$60.88
73564 X-ray of knee, 4 or more views	35	35	$54.07	$11.97
73030 X-ray of shoulder, minimum of 2 views	35	33	$44.32	$11.22
73521 X-ray of both hips, 2 views	30	30	$64.76	$11.88
72100 X-ray of lower and sacral spine, 2-3 views	28	28	$48.62	$12.69
73630 X-ray of foot, minimum of 3 views	23	18	$47.61	$8.27
73110 X-ray of wrist, minimum of 3 views	21	18	$36.47	$8.61
73560 X-ray of knee, 1-2 views	19	13	$41.53	$11.76
73562 X-ray of knee, 3 views	17	17	$50.96	$11.53
73610 X-ray of ankle, minimum of 3 views	15	13	$38.49	$10.09

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	324	169	$75.62	$70.13
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	165	125	$111.79	$102.95
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	102	102	$171.64	$157.01
J0702 Injection, betamethasone acetate 3 mg and betamethasone sodium phosphate 3 mg	53	21	$9.18	$6.46
73030 X-ray of shoulder, minimum of 2 views	45	37	$121.97	$25.74
73610 X-ray of ankle, minimum of 3 views	28	21	$74.55	$18.82
73562 X-ray of knee, 3 views	27	27	$102.77	$27.66
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	27	27	$109.74	$105.29
72100 X-ray of lower and sacral spine, 2-3 views	25	24	$120.27	$27.67
20610 Aspiration and/or injection of fluid from large joint	25	19	$389.98	$60.28
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	24	19	$44.29	$42.27
73630 X-ray of foot, minimum of 3 views	21	17	$105.18	$26.20
73521 X-ray of both hips, 2 views	19	19	$135.66	$28.56
73110 X-ray of wrist, minimum of 3 views	18	13	$84.35	$24.44
73130 X-ray of hand, minimum of 3 views	17	15	$74.80	$18.71
73560 X-ray of knee, 1-2 views	16	11	$82.00	$23.17
99221 Initial hospital inpatient care per day, typically 30 minutes	13	13	$103.12	$98.55

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License VI 653

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Tricare

V1000011 (VI)

Commercial Insurance / Payer ID Npi

1780671909 (VI)

Commercial Insurance / Payer ID Triple S

53699PE (VI)

Commercial Insurance / Payer ID Blue Cross Blue Shield Vi

089045 (VI)

Commercial Insurance / Payer ID Humana

0500138 (VI)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events

✅

NPI Profile Active December 11, 2007

NPI status registered as active in NPPES database

📍

Updated Practice Location December 11, 2007

Registered at SUNNY ISLE PROFESSIONAL BUILDING, SUITE 3-F, ST. CROIX, VI 008204423 (Tel: 3407786110)

📍

Updated Business Mailing Address December 11, 2007

Registered at PO BOX 7840, SUNNY ISLE PROFESSIONAL BLDG, STE 3, ST CROIX, VI 008237840 (Tel: 3407786110)

👤

Provider Name / Credentials Updated December 11, 2007

Recorded as WALTER PEDERSEN, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) December 11, 2007

Specialist (License #653 in VI)

🟢

Initial NPI Registration & Enumeration October 03, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

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NPI Administrative Meta

NPI Number: 1780671909

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: October 03, 2005

Last Update: December 11, 2007

Sole Proprietor: Yes

Update or Correct Profile

Mailing Address

Po Box 7840, Sunny Isle Professional Bldg, Ste 3

St Croix, VI 008237840

Phone: 3407786110

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.