MRS. ANNA MCCAMY GUNDERSON (PA-C) – Medical Physician Assistant, NPI 1174872345
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,531 PHYSICIAN ASSISTANT in ID
Provider Addresses for MRS. ANNA MCCAMY GUNDERSON (PA-C)
10 S Main St Ste 104
Victor, ID 834551034
Phone: (208) 783-3115
Fax: (800) 859-4576
Type: Location
1510 River Meadows Dr
Victor, ID 834554795
Phone: (208) 783-3115
Fax: (800) 859-4576
Type: Location
227 N 14TH AVE
POCATELLO, ID 832014145
Phone: (801) 573-1517
Type: Mailing
120 E HOWARD ST
DRIGGS, ID 834225112
Phone: (208) 354-2302
Fax: (208) 354-2829
Type: Location
PO BOX 1104
VICTOR, ID 834551032
Phone: (208) 783-3115
Fax: (800) 859-4576
Type: Mailing
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 $74.
Total Amount is formed as General ($74) + Research ($0) + Ownership ($0) = $74.
Last reported payment date: 2024-12-05 • Largest payer in this snapshot: ABBVIE INC. ($55).
Total Amount
$74
General + Research + Ownership
Payments
3
Total payment records
General Amount
$74
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-05
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $55 |
| Teva Pharmaceuticals USA, Inc. | $19 |
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: 2012-11-27
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 |
|---|---|---|---|---|
| I20121127000580 | I | Physician Assistant | ID | 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 83455)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | ID | |
| - | ID | |
| Family Practice | ID | |
| H O S P I T A L I S T | AZ | |
| Physical Therapist In Private Practice | ID | |
| D E R M A T O L O G Y | ID | |
| - | UT | |
| Family Practice | ID | |
| Internal Medicine | ID | |
| Physical Therapist In Private Practice | IL |
Reviews
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