CARLY ANDERSON – Physician Assistant, NPI 1154963676

CARLY ANDERSON is a healthcare provider. based in Pompton plains, New Jersey. specializing in Physician Assistant. The NPI Number for CARLY ANDERSON is 1154963676

Main info

Female
7 Years Of Experience
Accepts Medicare Assignment
Name
CARLY ANDERSON
NPI
1154963676
Phone
(973) 513-2377
Address
95 Hopper Ave
Enumeration Date
16 October 2019
Last Update Date
28 February 2020

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2126392000
Graduation Year
2019 (7 years ago)
PAC ID
7214366640
Group Practice PAC ID
4082503354
Professional Enrollment ID
I20200406000771
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience27
Completeness75
Years active:6State licenses:0Digital endpointsOther names

Provider Addresses for CARLY ANDERSON

  • 95 Hopper Ave

    Pompton Plains, NJ 074441244

    Phone: (973) 513-2377

    Type: Location

  • Memorial Sloan Kettering Cancer Center, 1275, York Avenue, Lenox Hill, Manhattan Community Board 8, Manhattan, New York County, New York, 10065, United States

    NEW YORK, NY 100656007

    Phone: (212) 639-2000

    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: 2020-04-06

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
I20200406000771IPhysician AssistantNYTBD

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
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes4114$0
View full utilization report →

Insurance plans in this area (ZIP 07444)

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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: 4082503354View full group profile

Reviews

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Frequently asked questions

Can I use this page to confirm CARLY ANDERSON's NPI?
Yes. CARLY ANDERSON is listed with NPI 1154963676 in the public NPI dataset.
Does CMS list CARLY ANDERSON as active?
Yes — CARLY ANDERSON is active in the NPI listing used on this page.
What is CARLY ANDERSON's primary classification?
Physician Assistant is the headline specialty for CARLY ANDERSON here. Clinical services aligned with this taxonomy classification.
Where should I expect CARLY ANDERSON on a map?
Expect Pompton Plains, New Jersey as a primary anchor for CARLY ANDERSON unless the record lists multiple sites.
How many locations tie to this NPI?
3 practice locations appear in the available data.

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