LISA M ANDERSON (MD) – Emergency Medicine Physician, NPI 1083679989
Emergency Medicine Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
487 EMERGENCY MEDICINE in UT
Provider Addresses for LISA M ANDERSON (MD)
PO BOX 198560
ATLANTA, GA 303848560
Phone:
Type: Mailing
10433 S REDWOOD RD STE 2
SOUTH JORDAN, UT 840958502
Phone: (801) 260-1919
Fax: (801) 260-1441
Type: Mailing
1126 E 12300 S
DRAPER, UT 840209095
Phone: (801) 545-0500
Fax: (801) 545-0626
Type: Location
1600, Snow Creek Drive, Park City, Summit County, Utah, 84060, United States
PARK CITY, UT 840607372
Phone: (435) 655-0055
Fax: (435) 655-8979
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 3 Open Payments records for all available years, with a total value of $50.
Total Amount is formed as General ($50) + Research ($0) + Ownership ($0) = $50.
Last reported payment date: 2023-04-07 • Largest payer in this snapshot: Alkermes, Inc. ($20).
Total Amount
$50
General + Research + Ownership
Payments
3
Total payment records
General Amount
$50
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-04-07
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Alkermes, Inc. | $20 |
| IDORSIA PHARMACEUTICALS US INC | $16 |
| Lucid Diagnostics Inc. | $15 |
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: 2006-01-19
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 |
|---|---|---|---|---|
| I20060119000883 | I | Emergency Medicine | UT | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 20 | 20 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 14 | 13 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 13 | 12 | $0 |
Insurance plans in this area (ZIP 30384)
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