DR. EDWIN A. ANDERSON (MD) – Family Medicine Physician, NPI 1083691828

DR. EDWIN A. ANDERSON (MD) is a healthcare provider. based in Grand rapids, Minnesota. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 40223 (MN). The NPI Number for DR. EDWIN A. ANDERSON (MD) is 1083691828

Main info

Male
31 Years Of Experience
Accepts Medicare Assignment
Name
DR. EDWIN A. ANDERSON (MD)
NPI
1083691828
Phone
(218) 326-5000
Address
1601 GOLF COURSE RD
Enumeration Date
22 December 2005
Last Update Date
3 April 2012

Doctor Profile

Medical School Name
UNIVERSITY OF MINNESOTA MEDICAL SCHOOL
Secondary Phone
-
Graduation Year
1995 (31 years ago)
PAC ID
9436246964
Group Practice PAC ID
4880681303
Professional Enrollment ID
I20071031000450
Address ID
MN566284346BI135XXDRXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

3,075 FAMILY PRACTICE in MN

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Provider Addresses for DR. EDWIN A. ANDERSON (MD)

  • Grand Itasca Clinic and Hospital, 1601, Golf Course Road, North Star Moblie Home Park, Grand Rapids, Itasca County, Minnesota, 55744, United States

    GRAND RAPIDS, MN 557448648

    Phone: (218) 326-5000

    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)

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: 2007-10-31

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
I20071031000450IFamily PracticeMNTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99283Emergency department visit with low level of medical decision making4542$0
99238Hospital discharge day management, 30 minutes or less2726$0
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes2416$0
View full utilization report →

Insurance plans in this area (ZIP 55744)

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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: 4880681303View full group profile

Reviews

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Frequently asked questions

Can I cross-check DR. EDWIN A. ANDERSON (MD) using NPI 1083691828?
NPI 1083691828 belongs to DR. EDWIN A. ANDERSON (MD); compare other details if you need extra assurance.
Is DR. EDWIN A. ANDERSON (MD) shown as active in public data?
Registry records indicate DR. EDWIN A. ANDERSON (MD) maintains an active NPI.
What expertise is attributed to DR. EDWIN A. ANDERSON (MD)?
DR. EDWIN A. ANDERSON (MD)'s specialty line reads Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where in Minnesota is DR. EDWIN A. ANDERSON (MD) registered?
Use Grand Rapids, Minnesota as the headline location for DR. EDWIN A. ANDERSON (MD) here.
When was this NPI issued?
Enumeration for DR. EDWIN A. ANDERSON (MD) is noted as December 22, 2005 where the registry provides it.

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