BRYCE WADE ANDERSEN (NP-C) – Primary Care Nurse Practitioner, NPI 1174955306

BRYCE WADE ANDERSEN (NP-C) is a healthcare provider. based in Rigby, Idaho. specializing in NURSE PRACTITIONER. They hold the professional credentials NP-C. They hold a License No. NP1303A (ID). The NPI Number for BRYCE WADE ANDERSEN (NP-C) is 1174955306

Main info

Male
13 Years Of Experience
Accepts Medicare Assignment
Name
BRYCE WADE ANDERSEN (NP-C)
NPI
1174955306
Phone
(208) 521-3870
Address
3380 E 155 N
Enumeration Date
30 July 2013
Last Update Date
11 March 2024

Doctor Profile

Medical School Name
UNIVERSITY OF UTAH SCHOOL OF MEDICINE
Secondary Phone
2085427100
Graduation Year
2013 (13 years ago)
PAC ID
2961636097
Group Practice PAC ID
4486562774
Professional Enrollment ID
I20131003000514
Address ID
ID834045049ID2730XWAYX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:12State licenses:1Digital endpointsOther names

1,798 NURSE PRACTITIONER in ID

Provider Addresses for BRYCE WADE ANDERSEN (NP-C)

  • 3380 E 155 N

    RIGBY, ID 834425272

    Phone: (208) 521-3870

    Type: Mailing

  • 2730 CHANNING WAY

    IDAHO FALLS, ID 834045049

    Phone: (208) 542-7100

    Type: Location

  • 690 N 700 E

    FIRTH, ID 832361134

    Phone: (208) 521-3870

    Type: Mailing

  • 3385 POTOMAC WAY

    IDAHO FALLS, ID 834044978

    Phone: (208) 522-7246

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 10 Open Payments records for all available years, with a total value of $330.

Total Amount is formed as General ($330) + Research ($0) + Ownership ($0) = $330.

Last reported payment date: 2024-12-09 • Largest payer in this snapshot: Actelion Pharmaceuticals US, Inc. ($93).

Total Amount

$330

General + Research + Ownership

Payments

10

Total payment records

General Amount

$330

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-09

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2013-10-03

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20131003000514INurse PractitionerIDTBD

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.

Verify on CMS Revalidation Lookup Tool

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 83442)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4486562774View full group profile
NameSpecialtyState
-ID
Certified Registered Nurse Anesthetist (Crna)ID
Osteopathic Manipulative MedicineWY
Physical Medicine And RehabilitationID
Nurse PractitionerTX
Qualified AudiologistID
Certified Registered Nurse Anesthetist (Crna)TX
Cardiovascular Disease (Cardiology), Internal MedicineID
Nurse PractitionerID
U R O L O G YKY

Reviews

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Frequently asked questions

Can I verify BRYCE WADE ANDERSEN (NP-C) with an NPI only?
You can start verification with NPI 1174955306 for BRYCE WADE ANDERSEN (NP-C), then check state licensing separately.
Can I rely on BRYCE WADE ANDERSEN (NP-C) being an active provider?
As of the registry snapshot, BRYCE WADE ANDERSEN (NP-C) is marked active.
What is BRYCE WADE ANDERSEN (NP-C)'s specialty?
The listing groups BRYCE WADE ANDERSEN (NP-C) with Primary Care Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What address line appears for BRYCE WADE ANDERSEN (NP-C)?
BRYCE WADE ANDERSEN (NP-C)'s geographic hint is Rigby, Idaho in our summary view.
Why does BRYCE WADE ANDERSEN (NP-C) have multiple addresses?
4 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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