ABBY L ANDERSON (PA-C) – Physician Assistant, NPI 1093795783

ABBY L ANDERSON (PA-C) is a healthcare provider. based in South bend, Indiana. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. They hold a License No. 5601003712 (MI). The NPI Number for ABBY L ANDERSON (PA-C) is 1093795783

Main info

Female
25 Years Of Experience
Accepts Medicare Assignment
Name
ABBY L ANDERSON (PA-C)
NPI
1093795783
Phone
(574) 647-5300
Address
100 NAVARRE PL STE 4440
Enumeration Date
19 January 2006
Last Update Date
22 January 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2001 (25 years ago)
PAC ID
5496857625
Group Practice PAC ID
0244136067
Professional Enrollment ID
I20070219000533
Address ID
MI492011753JA205XXAVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience69
Completeness75
Years active:20State licenses:1Digital endpointsOther names

2,499 PHYSICIAN ASSISTANT in IN

Provider Addresses for ABBY L ANDERSON (PA-C)

  • 100 NAVARRE PL STE 4440

    SOUTH BEND, IN 466011171

    Phone: (574) 647-5300

    Fax: (574) 647-5305

    Type: Location

  • 710, North Niles Avenue, South Bend, Saint Joseph County, Indiana, 46617, United States

    SOUTH BEND, IN 466171924

    Phone: (574) 647-1610

    Type: Mailing

  • 205 N EAST AVE

    JACKSON, MI 492011753

    Phone: (517) 205-4800

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $77.

Total Amount is formed as General ($77) + Research ($0) + Ownership ($0) = $77.

Last reported payment date: 2024-11-06 • Largest payer in this snapshot: ATRICURE, INC. ($77).

Total Amount

$77

General + Research + Ownership

Payments

3

Total payment records

General Amount

$77

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-06

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
ATRICURE, INC.$77
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: 2007-02-19

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
I20070219000533IPhysician AssistantMITBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes5339$0
99239Hospital discharge day management, more than 30 minutes2323$0
View full utilization report →

Insurance plans in this area (ZIP 46601)

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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: 0244136067View full group profile

Reviews

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Frequently asked questions

What is the 10-digit NPI for ABBY L ANDERSON (PA-C)?
ABBY L ANDERSON (PA-C) — NPI 1093795783 — is the standard way to identify this listing.
Is ABBY L ANDERSON (PA-C) listed as active for patients and plans?
The listing shows ABBY L ANDERSON (PA-C) as active in the NPI system.
What healthcare role does ABBY L ANDERSON (PA-C) hold?
Scheduling teams often label ABBY L ANDERSON (PA-C) under Physician Assistant. Clinical services aligned with this taxonomy classification.
Where should I expect ABBY L ANDERSON (PA-C) on a map?
Expect South Bend, Indiana as a primary anchor for ABBY L ANDERSON (PA-C) unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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