MR. JON E ANDERSEN (DO) – Surgery Physician, NPI 1841304888
Surgery Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
1,423 GENERAL SURGERY in IL
Provider Addresses for MR. JON E ANDERSEN (DO)
390 MAPLE SUMMIT RD
JERSEYVILLE, IL 620522000
Phone: (618) 498-2101
Fax: (618) 498-2787
Type: Location
400 Maple Summit Rd
Jerseyville, IL 620522028
Phone: (618) 498-8362
Fax: (618) 498-8391
Type: Location
Jersey Community Hospital, 400, Maple Summit Road, Jerseyville, Jersey County, Illinois, 62052, United States
JERSEYVILLE, IL 620522028
Phone: (618) 498-8362
Fax: (618) 498-8391
Type: Location
390, Maple Summit Road, Jerseyville, Jersey County, Illinois, 62052, United States
JERSEYVILLE, IL 620522000
Phone: (618) 498-7518
Fax: (618) 498-3052
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $175.
Total Amount is formed as General ($175) + Research ($0) + Ownership ($0) = $175.
Last reported payment date: 2024-10-08 • Largest payer in this snapshot: Organogenesis Inc. ($141).
Total Amount
$175
General + Research + Ownership
Payments
4
Total payment records
General Amount
$175
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-08
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Organogenesis Inc. | $141 |
| Kerecis Limited | $22 |
| LifeNet Health | $12 |
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: 2008-02-13
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 |
|---|---|---|---|---|
| I20080213000164 | I | General Surgery | IL | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99212 | Established patient office or other outpatient visit, 10-19 minutes | 177 | 68 | $0 |
| 11042 | Removal of skin and tissue, 20.0 sq cm or less | 50 | 15 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 21 | 20 | $0 |
| 99202 | New patient office or other outpatient visit, 15-29 minutes | 18 | 18 | $0 |
| 99203 | New patient office or other outpatient visit, 30-44 minutes | 12 | 12 | $0 |
Insurance plans in this area (ZIP 62052)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| GENERAL SURGERY | IL | 11042 | Removal of skin and tissue first 20 sq cm or less | 93 | 23 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| - | IL | |
| Certified Registered Nurse Anesthetist (Crna) | IL | |
| - | NY | |
| Certified Registered Nurse Anesthetist (Crna) | IL | |
| Certified Registered Nurse Anesthetist (Crna) | IL | |
| Cardiovascular Disease (Cardiology) | MO | |
| G A S T R O E N T E R O L O G Y | MO | |
| - | NC | |
| - | IL | |
| Certified Registered Nurse Anesthetist (Crna) | IL |
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