EDWARD L ANDRADA (MD) – Family Medicine Physician, NPI 1730145814
Family Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for EDWARD L ANDRADA (MD)
1600 W C Pl
Russellville, AR 728012705
Phone: (479) 967-7717
Fax: (866) 280-8464
Type: Location
Milliard-Henry Clinic, 101, Skyline Drive, Norristown, Russellville, Pope County, Arkansas, 72801, United States
RUSSELLVILLE, AR 728013363
Phone: (479) 968-2345
Fax: (479) 890-2467
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2004-02-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040207000433 | I | Family Practice | AR | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 72801)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | AR | |
| - | AR | |
| Nurse Practitioner | AR | |
| General Surgery | OK | |
| Family Practice | AR | |
| Nurse Practitioner | AR | |
| - | AR | |
| O B S T E T R I C S/ G Y N E C O L O G Y | AR | |
| Nurse Practitioner | TN | |
| Nurse Practitioner | AR |
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