ANDY JAY EDWARDS (MSN, APRN, FNP-C) – Psychiatric/Mental Health Nurse Practitioner, NPI 1063910933
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,657 NURSE PRACTITIONER in UT
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Provider Addresses for ANDY JAY EDWARDS (MSN, APRN, FNP-C)
100, Oceangate, Long Beach, Los Angeles County, California, 90802, United States
LONG BEACH, CA 908024317
Phone: (888) 562-5442
Fax: (562) 499-6171
Type: Mailing
Union Park, Midvale, Salt Lake County, Utah, United States
#200
MIDVALE, UT 840474171
Phone: (888) 562-5442
Fax: (562) 499-6171
Type: Location
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: 2025-10-28
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 5 Medicare enrollment records; no due dates published yet.
Enrollment records
5
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 |
|---|---|---|---|---|
| I20180501000805 | I | Nurse Practitioner | UT | TBD |
| I20201119001946 | I | Nurse Practitioner | WA | TBD |
| I20210426002612 | I | Nurse Practitioner | ID | TBD |
| I20230516001636 | I | Nurse Practitioner | NV | TBD |
| I20251028001753 | I | Nurse Practitioner | CT | 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 90802)
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