MR. EDWARD CARL ANDERSON (PA) – Physician Assistant, NPI 1326104910

MR. EDWARD CARL ANDERSON (PA) is a healthcare provider. based in Granite city, Illinois. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 109142 (MO). The NPI Number for MR. EDWARD CARL ANDERSON (PA) is 1326104910

Main info

Male
47 Years Of Experience
Name
MR. EDWARD CARL ANDERSON (PA)
NPI
1326104910
Phone
(618) 452-3301
Address
2100 MADISON AVE
Enumeration Date
28 December 2006
Last Update Date
9 August 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6186288211
Graduation Year
1979 (47 years ago)
PAC ID
6204724370
Group Practice PAC ID
6103264510
Professional Enrollment ID
I20040309001218
Address ID
IL622691848OX916XXDRXX300
Telehealth
Yes

Contacts

Secure Messaging
edward.anderson.1@9559.direct.athenahealth.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience71
Completeness85
Years active:19State licenses:2Other namesUpdated within 12 months

5,035 PHYSICIAN ASSISTANT in IL

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Provider Addresses for MR. EDWARD CARL ANDERSON (PA)

  • Gateway Regional Medical Center, 2100, Madison Avenue, Granite City, Madison County, Illinois, 62040, United States

    GRANITE CITY, IL 620404701

    Phone: (618) 452-3301

    Fax: (618) 452-3312

    Type: Mailing

  • 2166 MADISON AVE

    GRANITE CITY, IL 620404700

    Phone: (618) 452-3301

    Fax: (618) 452-3312

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 167 Open Payments records for all available years, with a total value of $2,738.

Total Amount is formed as General ($2,738) + Research ($0) + Ownership ($0) = $2,738.

Last reported payment date: 2024-12-17 • Largest payer in this snapshot: ABBVIE INC. ($478).

Total Amount

$2,738

General + Research + Ownership

Payments

167

Total payment records

General Amount

$2,738

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-17

Latest reported date

Top Companies

Largest payers in this snapshot

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: 2004-03-09

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
I20040309001218IPhysician AssistantILTBD

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 62040)

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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: 6103264510View full group profile
NameSpecialtyState
Nurse PractitionerIL
Physical Therapist In Private PracticeIL
Physical Therapist In Private PracticeIL
Nurse PractitionerIN
Pain Management, Physical Medicine And Rehabilitation, Physical Medicine And Rehabilitation, Pain ManagementMO
Nurse PractitionerIL
Nurse PractitionerIL
Nurse PractitionerAZ
Physical Therapist In Private PracticeIL
Family PracticeIL

Reviews

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Frequently asked questions

Can I cross-check MR. EDWARD CARL ANDERSON (PA) using NPI 1326104910?
NPI 1326104910 belongs to MR. EDWARD CARL ANDERSON (PA); compare other details if you need extra assurance.
Would MR. EDWARD CARL ANDERSON (PA) appear as active to a payer?
You can treat MR. EDWARD CARL ANDERSON (PA) as active for directory purposes; confirm clinical privileges separately.
How would a patient describe MR. EDWARD CARL ANDERSON (PA)'s focus?
For MR. EDWARD CARL ANDERSON (PA), the primary taxonomy reads as Physician Assistant. Clinical services aligned with this taxonomy classification.
Is MR. EDWARD CARL ANDERSON (PA) located near Granite City?
MR. EDWARD CARL ANDERSON (PA) currently maps to Granite City, Illinois in this extract.
Can I trust this NPI listing for MR. EDWARD CARL ANDERSON (PA)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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