BRYCE WADE ANDERSEN (NP-C) – Primary Care Nurse Practitioner, NPI 1174955306
Primary Care Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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
Top Companies
Largest payers in this snapshot
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20131003000514 | I | Nurse Practitioner | 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 83442)
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Group practice members
- 1
- 2
- 3
- 4
| Name | Specialty | State |
|---|---|---|
| - | ID | |
| Certified Registered Nurse Anesthetist (Crna) | ID | |
| Osteopathic Manipulative Medicine | WY | |
| Physical Medicine And Rehabilitation | ID | |
| Nurse Practitioner | TX | |
| Qualified Audiologist | ID | |
| Certified Registered Nurse Anesthetist (Crna) | TX | |
| Cardiovascular Disease (Cardiology), Internal Medicine | ID | |
| Nurse Practitioner | ID | |
| U R O L O G Y | KY |
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