ANDERSON CARTER – Emergency Medicine Physician, NPI 1053061390

ANDERSON CARTER is a healthcare provider. based in Oak lawn, Illinois. specializing in EMERGENCY MEDICINE. They hold a License No. 036171180 (IL). The NPI Number for ANDERSON CARTER is 1053061390

Main info

Male
4 Years Of Experience
Accepts Medicare Assignment
Name
ANDERSON CARTER
NPI
1053061390
Phone
(708) 684-5375
Address
4440 W 95TH ST
Enumeration Date
28 March 2022
Last Update Date
12 May 2025

Doctor Profile

Medical School Name
UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Secondary Phone
8153001100
Graduation Year
2022 (4 years ago)
PAC ID
6103331582
Group Practice PAC ID
6103925920
Professional Enrollment ID
I20250715001325
Address ID
IL604519509NE1900XBLVD400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:4State licenses:1Digital endpointsOther names

2,845 EMERGENCY MEDICINE in IL

Provider Addresses for ANDERSON CARTER

  • 4440 W 95TH ST

    OAK LAWN, IL 604532600

    Phone: (708) 684-5375

    Fax: (708) 684-3776

    Mailing address matches the actual address.

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: 2025-07-15

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
I20250715001325IEmergency MedicineILTBD

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 60453)

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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: 6103925920View full group profile
NameSpecialtyState
Emergency MedicineIL
Emergency MedicineMI
Nurse PractitionerIL
-IL
Emergency MedicineIL
-IL
Nurse PractitionerIL
Emergency MedicineLA
Emergency MedicineIL
Emergency MedicineIL

Reviews

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Frequently asked questions

Can I verify ANDERSON CARTER with an NPI only?
You can start verification with NPI 1053061390 for ANDERSON CARTER, then check state licensing separately.
Is ANDERSON CARTER listed as active for patients and plans?
The listing shows ANDERSON CARTER as active in the NPI system.
What healthcare role does ANDERSON CARTER hold?
Scheduling teams often label ANDERSON CARTER under Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
What area does ANDERSON CARTER serve?
ANDERSON CARTER's listing highlights Oak Lawn, Illinois; more addresses can appear in NPPES.
Why does ANDERSON CARTER have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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