Keely E. Pedersen, PA-C
NPI 1619228624ActiveIndividual· Physician Assistant· Lake Forest, IL
Physician Assistant (PA-C) with Northwestern Medical Faculty Foundation and 1 other group, practicing in Lake Forest, Illinois. 74 Medicare patients in 2024, $7,723 paid; nearly all of their 116 Part D prescriptions were generic (94%).
Overview
| NPI | 1619228624 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA-C |
| Sole proprietor | No |
| NPI issued | Oct 1, 2012 |
| Last updated in NPPES | Nov 11, 2024 |
| Certified by provider | Nov 11, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant Primary | 363A00000X | 085004520 | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (IL) |
|---|---|
| Accepts assignment | Yes (participating) |
Medicare services in 2024
| Medicare patients | 74 |
|---|---|
| Services billed | 164 across 38 procedure codes |
| Paid by Medicare | $7,723 |
Part D prescriptions in 2024
| Prescriptions (claims) | 116 · 117 30-day fills |
|---|---|
| Patients | 83 |
| Total drug cost | $1,594 |
| Generic share | 94% of claims |
Education and affiliations
| Graduation year | 2009 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical groups
- Northwestern Medical Faculty FoundationChicago, IL · 4,503 clinicians
- Lake County Immediate Care, LLCHighland Park, IL · 15 clinicians
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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All 69 physician assistants in Lake Forest · All physician assistants in Illinois