DR. MICKEY DALE ANDERSON (MD) – Surgery Physician, NPI 1497728323

DR. MICKEY DALE ANDERSON (MD) is a healthcare provider. based in London, Kentucky. specializing in GENERAL SURGERY. They hold the professional credentials MD. They hold a License No. 20844 (KY). The NPI Number for DR. MICKEY DALE ANDERSON (MD) is 1497728323

Main info

Male
47 Years Of Experience
Accepts Medicare Assignment
Name
DR. MICKEY DALE ANDERSON (MD)
NPI
1497728323
Phone
(606) 330-7840
Address
PO BOX 936
Enumeration Date
10 February 2006
Last Update Date
6 May 2019

Doctor Profile

Medical School Name
UNIVERSITY OF LOUISVILLE SCHOOL OF MEDICINE
Secondary Phone
5023485588
Graduation Year
1979 (47 years ago)
PAC ID
6305812850
Professional Enrollment ID
I20040907000323
Address ID
KY400049096BA118XXDRXX303
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

539 GENERAL SURGERY in KY

Provider Addresses for DR. MICKEY DALE ANDERSON (MD)

  • The Box, 4-6, Ram Place, Homerton, London Borough of Hackney, London, Greater London, England, E9 6LT, United Kingdom

    LONDON, KY 407430936

    Phone: (606) 330-7840

    Fax: (606) 330-7825

    Type: Mailing

  • 118 PATRIOT DR

    SUITE 203

    BARDSTOWN, KY 400049093

    Phone: (502) 348-5588

    Fax: (502) 348-1046

    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: 2004-09-07

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
I20040907000323IGeneral SurgeryKYTBD

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
99213Established patient office or other outpatient visit, 20-29 minutes144108$0
99203New patient office or other outpatient visit, 30-44 minutes5959$0
45378Diagnostic exam of large bowel using a flexible endoscope5856$0
43239Biopsy of esophagus, stomach, and/or upper small bowel using a flexible endoscope5858$0
99214Established patient office or other outpatient visit, 30-39 minutes2416$0
View full utilization report →

Insurance plans in this area (ZIP 40743)

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Reviews

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Frequently asked questions

How do payers reference DR. MICKEY DALE ANDERSON (MD)?
For DR. MICKEY DALE ANDERSON (MD), use NPI 1497728323 as the unique 10-digit identifier.
Is there an active status for DR. MICKEY DALE ANDERSON (MD)?
For scheduling context, DR. MICKEY DALE ANDERSON (MD) is shown as active in the registry.
How would a patient describe DR. MICKEY DALE ANDERSON (MD)'s focus?
For DR. MICKEY DALE ANDERSON (MD), the primary taxonomy reads as Surgery Physician. Clinical services aligned with this taxonomy classification.
Where in Kentucky is DR. MICKEY DALE ANDERSON (MD) registered?
Use London, Kentucky as the headline location for DR. MICKEY DALE ANDERSON (MD) here.
Can I trust this NPI listing for DR. MICKEY DALE ANDERSON (MD)?
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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