ALYSSA LYNN ANDERSON (PA) – Physician Assistant, NPI 1538846928

ALYSSA LYNN ANDERSON (PA) is a healthcare provider. based in Omaha, Nebraska. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA. They hold a License No. 3191 (NE). The NPI Number for ALYSSA LYNN ANDERSON (PA) is 1538846928

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
ALYSSA LYNN ANDERSON (PA)
NPI
1538846928
Phone
(712) 310-5834
Address
720 N 129TH ST
Enumeration Date
28 June 2023
Last Update Date
4 February 2025

Doctor Profile

Medical School Name
UNIVERSITY OF NEBRASKA COLLEGE OF MEDICINE
Secondary Phone
4023970670
Graduation Year
2024 (2 years ago)
PAC ID
6103344981
Group Practice PAC ID
3173517539
Professional Enrollment ID
I20250515001536
Address ID
NE681546109OM720XXSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

1,396 PHYSICIAN ASSISTANT in NE

Provider Addresses for ALYSSA LYNN ANDERSON (PA)

  • 720 N 129TH ST

    OMAHA, NE 681546109

    Phone: (712) 310-5834

    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: 2025-05-15

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
I20250515001536IPhysician AssistantNETBD

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 68154)

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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: 3173517539View full group profile
NameSpecialtyState
-NE
Qualified AudiologistNE
O T O L A R Y N G O L O G YOH
-NE
O T O L A R Y N G O L O G YTX
Qualified AudiologistNE
Qualified AudiologistNE
O T O L A R Y N G O L O G YNE
O T O L A R Y N G O L O G YNE
-NE

Reviews

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Frequently asked questions

Can I verify ALYSSA LYNN ANDERSON (PA) with an NPI only?
You can start verification with NPI 1538846928 for ALYSSA LYNN ANDERSON (PA), then check state licensing separately.
Does CMS list ALYSSA LYNN ANDERSON (PA) as active?
Yes — ALYSSA LYNN ANDERSON (PA) is active in the NPI listing used on this page.
What is ALYSSA LYNN ANDERSON (PA)'s primary classification?
Physician Assistant is the headline specialty for ALYSSA LYNN ANDERSON (PA) here. Clinical services aligned with this taxonomy classification.
Where should I expect ALYSSA LYNN ANDERSON (PA) on a map?
Expect Omaha, Nebraska as a primary anchor for ALYSSA LYNN ANDERSON (PA) unless the record lists multiple sites.
Is the information about ALYSSA LYNN ANDERSON (PA) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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