DR. JESSE STEPHEN ANDERSEN (MD) – Emergency Medicine Physician, NPI 1407506413

DR. JESSE STEPHEN ANDERSEN (MD) is a healthcare provider. based in Coldwater, Michigan. specializing in EMERGENCY MEDICINE. They hold the professional credentials MD. They hold a License No. 4301515312 (MI). The NPI Number for DR. JESSE STEPHEN ANDERSEN (MD) is 1407506413

Main info

Male
Sole Proprietor
4 Years Of Experience
Accepts Medicare Assignment
Name
DR. JESSE STEPHEN ANDERSEN (MD)
NPI
1407506413
Phone
(517) 279-5400
Address
274 E Chicago St
Enumeration Date
24 March 2022
Last Update Date
19 November 2025

Doctor Profile

Medical School Name
MEDICAL UNIVERSITY OF SOUTH CAROLINA COLLEGE OF MEDICINE
Secondary Phone
5172795400
Graduation Year
2022 (4 years ago)
PAC ID
1759762420
Group Practice PAC ID
3870493588
Professional Enrollment ID
I20260120003922
Address ID
MI490362041CO274XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness85
Years active:4State licenses:1Digital endpointsOther names

3,157 EMERGENCY MEDICINE in MI

Provider Addresses for DR. JESSE STEPHEN ANDERSEN (MD)

  • 274 E Chicago St

    Coldwater, MI 490362041

    Phone: (517) 279-5400

    Type: Location

  • 36475 FIVE MILE RD

    LIVONIA, MI 481541971

    Phone: (734) 655-4800

    Fax: (734) 655-2911

    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: 2026-01-20

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
I20260120003922IEmergency MedicineMITBD

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 49036)

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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: 3870493588View full group profile
NameSpecialtyState
Emergency MedicineMI
-PA
Physician AssistantMI
Emergency MedicineMI
Emergency MedicineMI
Nurse PractitionerMI
-MI
Emergency MedicineMI
Emergency MedicineMI
-PA

Reviews

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Frequently asked questions

Is DR. JESSE STEPHEN ANDERSEN (MD) listed with a National Provider Identifier?
Yes — DR. JESSE STEPHEN ANDERSEN (MD) has NPI 1407506413 on file in the registry.
Active or inactive — what applies to DR. JESSE STEPHEN ANDERSEN (MD)?
You should see DR. JESSE STEPHEN ANDERSEN (MD) as active in CMS-hosted NPPES data.
What area of care is associated with DR. JESSE STEPHEN ANDERSEN (MD)?
DR. JESSE STEPHEN ANDERSEN (MD)'s record emphasizes Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
Is DR. JESSE STEPHEN ANDERSEN (MD) located near Coldwater?
DR. JESSE STEPHEN ANDERSEN (MD) currently maps to Coldwater, Michigan in this extract.
Can I trust this NPI listing for DR. JESSE STEPHEN ANDERSEN (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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