SARA J ANDERSON-KIM (APNP) – Nurse Practitioner, NPI 1902057052
Nurse Practitioner
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
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Provider Addresses for SARA J ANDERSON-KIM (APNP)
2160, South 1st Avenue, Maywood, Proviso Township, Cook County, Illinois, 60153, United States
MAYWOOD, IL 601533328
Phone: (708) 216-9000
Type: Location
1821 S Stoughton Rd
Madison, WI 537162257
Phone: (608) 260-6000
Fax: (608) 260-6161
Type: Location
2160 S 1st Ave
Maywood, IL 601533328
Phone: (708) 216-9000
Type: Location
752 N HIGH POINT RD
MADISON, WI 537172236
Phone: (608) 824-4000
Fax: (608) 824-4956
Type: Location
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: 2021-07-21
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 |
|---|---|---|---|---|
| I20210721002263 | I | Nurse Practitioner | WI | 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 60153)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| U R O L O G Y | WA | |
| - | WI | |
| O P T O M E T R Y | WI | |
| N E U R O S U R G E R Y | NE | |
| - | WI | |
| Physician Assistant | WI | |
| Family Practice | WI | |
| Cardiovascular Disease (Cardiology) | TX | |
| - | WI | |
| Family Practice | WI |
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