ELLEN M ANDERSON (DPM) – Podiatrist, NPI 1104928464

ELLEN M ANDERSON (DPM) is a healthcare provider. based in Dover foxcroft, Maine. specializing in PODIATRY. They hold the professional credentials DPM. They hold a License No. POD155 (ME). The NPI Number for ELLEN M ANDERSON (DPM) is 1104928464

Main info

Female
Sole Proprietor
46 Years Of Experience
Accepts Medicare Assignment
Name
ELLEN M ANDERSON (DPM)
NPI
1104928464
Phone
(207) 564-2536
Address
839 W MAIN ST
Enumeration Date
5 September 2006
Last Update Date
5 February 2015

Doctor Profile

Medical School Name
TEMPLE UNIVERSITY SCHOOL OF PODIATRIC MEDICINE
Secondary Phone
2079245200
Graduation Year
1980 (46 years ago)
PAC ID
7911938972
Group Practice PAC ID
8224924576
Professional Enrollment ID
I20050830000151
Address ID
ME049301320DE29XXXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

69 PODIATRY in ME

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Provider Addresses for ELLEN M ANDERSON (DPM)

  • 839, West Main Street, Dover-Foxcroft, Piscataquis County, Maine, 04426, United States

    DOVER FOXCROFT, ME 044261334

    Phone: (207) 564-2536

    Fax: (207) 564-8581

    Type: Location

  • PO BOX 327

    DOVER-FOXCROFT, ME 044260327

    Phone: (207) 564-2536

    Fax: (207) 564-8581

    Type: Mailing

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: 2005-08-30

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
I20050830000151IPodiatryMETBD

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 04426)

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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: 8224924576View full group profile
NameSpecialtyState
Nurse PractitionerME
Family PracticeME
-ME
Clinical Social WorkerME
Nurse PractitionerME
Clinical Social WorkerME
-ME
-ME
Clinical Social WorkerME
Nurse PractitionerME

Reviews

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Frequently asked questions

Where can patients find ELLEN M ANDERSON (DPM)'s NPI?
You can confirm ELLEN M ANDERSON (DPM) with NPI 1104928464; it appears in the national provider directory.
Is ELLEN M ANDERSON (DPM)'s NPI currently valid?
The extract we use shows ELLEN M ANDERSON (DPM) as active.
What does ELLEN M ANDERSON (DPM) treat or focus on?
Patients typically see ELLEN M ANDERSON (DPM) under the specialty Podiatrist. Clinical services aligned with this taxonomy classification.
What location metadata exists for ELLEN M ANDERSON (DPM)?
The page summarizes Dover Foxcroft, Maine for ELLEN M ANDERSON (DPM); expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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