ANDREA CLEGG (NP) – Nurse Practitioner, NPI 1285612861

ANDREA CLEGG (NP) is a healthcare provider. based in Dearborn, Michigan. specializing in NURSE PRACTITIONER. They hold the professional credentials NP. They hold a License No. 4704218011 (MI). The NPI Number for ANDREA CLEGG (NP) is 1285612861

Main info

Female
23 Years Of Experience
Accepts Medicare Assignment
Name
ANDREA CLEGG (NP)
NPI
1285612861
Phone
(313) 996-7280
Address
18101 OAKWOOD BLVD STE 101
Enumeration Date
4 January 2006
Last Update Date
5 January 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2003 (23 years ago)
PAC ID
3375504681
Group Practice PAC ID
7214299866
Professional Enrollment ID
I20041020000858
Address ID
MI483365970FA28100AVEX400

Contacts

Secure Messaging
aclegg115571@direct.beaumont.edu
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness85
Years active:20State licenses:1Other namesUpdated within 12 months

8,106 NURSE PRACTITIONER in MI

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Provider Addresses for ANDREA CLEGG (NP)

  • Oakwood Boulevard, Southwestern Outer Drive, Dearborn, Wayne County, Michigan, 48124, United States

    DEARBORN, MI 481244089

    Phone: (313) 996-7280

    Type: Mailing

  • 22060 BEECH ST STE 200

    DEARBORN, MI 481242853

    Phone: (313) 228-0505

    Fax: (313) 228-0506

    Type: Location

  • 26901 BEAUMONT BLVD STE 3D

    SOUTHFIELD, MI 480333849

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 55 Open Payments records for all available years, with a total value of $1,630.

Total Amount is formed as General ($1,630) + Research ($0) + Ownership ($0) = $1,630.

Last reported payment date: 2024-12-18 • Largest payer in this snapshot: Boehringer Ingelheim Pharmaceuticals, Inc. ($202).

Total Amount

$1,630

General + Research + Ownership

Payments

55

Total payment records

General Amount

$1,630

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-18

Latest reported date

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: 2004-10-20

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
I20041020000858INurse PractitionerMITBD

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 48124)

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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: 7214299866View full group profile
NameSpecialtyState
-MI
P S Y C H I A T R YMI
-MI
Interventional Cardiology, Cardiovascular Disease (Cardiology)MI
-MI
-MI
-MI
-MI
-MI
Physician AssistantMI

Reviews

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Frequently asked questions

Can I use this page to confirm ANDREA CLEGG (NP)'s NPI?
Yes. ANDREA CLEGG (NP) is listed with NPI 1285612861 in the public NPI dataset.
Is ANDREA CLEGG (NP) still practicing?
ANDREA CLEGG (NP) is currently listed as active in the public NPI registry.
What is ANDREA CLEGG (NP) best known for clinically?
Directory data describes ANDREA CLEGG (NP) with Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What area does ANDREA CLEGG (NP) serve?
ANDREA CLEGG (NP)'s listing highlights Dearborn, Michigan; more addresses can appear in NPPES.
Why does ANDREA CLEGG (NP) have multiple addresses?
4 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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