DR. MARY BETH ANDERSON (D.O.) – Dermatopathology (Pathology) Physician, NPI 1457419160

DR. MARY BETH ANDERSON (D.O.) is a healthcare provider. based in Clinton township, Michigan. specializing in Dermatopathology (Pathology) Physician. They hold the professional credentials D.O.. They hold a License No. 5101011355 (MI). The NPI Number for DR. MARY BETH ANDERSON (D.O.) is 1457419160

Main info

Female
Sole Proprietor
35 Years Of Experience
Accepts Medicare Assignment
Name
DR. MARY BETH ANDERSON (D.O.)
NPI
1457419160
Phone
(586) 381-0177
Address
18756 MILLAR RD
Enumeration Date
5 December 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
5862868720308
Graduation Year
1991 (35 years ago)
PAC ID
9436059748
Group Practice PAC ID
7012976590
Professional Enrollment ID
I20040112000469
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

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Provider Addresses for DR. MARY BETH ANDERSON (D.O.)

  • 18756, Millar Road, Metropole Parkway, Clinton Township, Macomb County, Michigan, 48036, United States

    CLINTON TOWNSHIP, MI 480362095

    Phone: (586) 381-0177

    Fax: (859) 987-7661

    Mailing address matches the actual address.

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 $80.

Total Amount is formed as General ($80) + Research ($0) + Ownership ($0) = $80.

Last reported payment date: 2024-11-13 • Largest payer in this snapshot: Regeneron Healthcare Solutions, Inc. ($52).

Total Amount

$80

General + Research + Ownership

Payments

3

Total payment records

General Amount

$80

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-13

Latest reported date

Top Companies

Largest payers in this snapshot

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: 2004-01-12

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
I20040112000469IPathologyMITBD

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 48036)

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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: 7012976590View full group profile
NameSpecialtyState
Physician AssistantMI
D E R M A T O L O G YMD
Physician AssistantMI
Nurse PractitionerMI
D E R M A T O L O G YMI
D E R M A T O L O G YMI
-MI
D E R M A T O L O G YMI
-MI
D E R M A T O L O G YMI

Reviews

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Frequently asked questions

What is the registry number for DR. MARY BETH ANDERSON (D.O.)?
The registry entry for DR. MARY BETH ANDERSON (D.O.) shows NPI 1457419160.
Does the public listing show DR. MARY BETH ANDERSON (D.O.) as active?
DR. MARY BETH ANDERSON (D.O.)'s NPI record reflects an active status in NPPES.
What services align with DR. MARY BETH ANDERSON (D.O.)'s listing?
DR. MARY BETH ANDERSON (D.O.)'s public classification highlights Dermatopathology (Pathology) Physician. Clinical services aligned with this taxonomy classification.
Can patients visit DR. MARY BETH ANDERSON (D.O.) in Clinton Township, Michigan?
For routing, start with Clinton Township, Michigan for DR. MARY BETH ANDERSON (D.O.), then verify phone and hours locally.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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