ANDREW ANDERSON – Family Nurse Practitioner, NPI 1780200022

ANDREW ANDERSON is a healthcare provider. based in Gladstone, Michigan. specializing in NURSE PRACTITIONER. They hold a License No. 4704297360 (MI). The NPI Number for ANDREW ANDERSON is 1780200022

Main info

Male
Sole Proprietor
6 Years Of Experience
Accepts Medicare Assignment
Name
ANDREW ANDERSON
NPI
1780200022
Phone
(906) 241-7436
Address
208 MICHIGAN AVE
Enumeration Date
23 June 2020
Last Update Date
23 June 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9063412153
Graduation Year
2020 (6 years ago)
PAC ID
3779993514
Group Practice PAC ID
4082525118
Professional Enrollment ID
I20201105000754
Address ID
MI498548992MA7870W2XXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

8,106 NURSE PRACTITIONER in MI

Provider Addresses for ANDREW ANDERSON

  • 208 MICHIGAN AVE

    GLADSTONE, MI 498371914

    Phone: (906) 241-7436

    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 6 Open Payments records for all available years, with a total value of $124.

Total Amount is formed as General ($124) + Research ($0) + Ownership ($0) = $124.

Last reported payment date: 2024-09-27 • Largest payer in this snapshot: ABBVIE INC. ($62).

Total Amount

$124

General + Research + Ownership

Payments

6

Total payment records

General Amount

$124

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-09-27

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: 2020-11-05

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
I20201105000754INurse 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 49837)

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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: 4082525118View full group profile
NameSpecialtyState
-MI
Family PracticeOH
-MI
Nurse PractitionerMI
Emergency Medicine, Internal MedicineMI
Nurse PractitionerMI
Nurse PractitionerMI
General PracticeMI
Orthopedic SurgeryMI
Nurse PractitionerMI

Reviews

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Frequently asked questions

Where can patients find ANDREW ANDERSON's NPI?
You can confirm ANDREW ANDERSON with NPI 1780200022; it appears in the national provider directory.
Does this profile mean ANDREW ANDERSON is currently active?
Yes — ANDREW ANDERSON appears active in the national provider directory.
Can you summarize ANDREW ANDERSON's specialty in plain language?
Clinically, the directory lists ANDREW ANDERSON with Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What location metadata exists for ANDREW ANDERSON?
The page summarizes Gladstone, Michigan for ANDREW ANDERSON; expand the address list for detail.
How can I contact ANDREW ANDERSON?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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