ANDROMEDA FAIR (CRNP) – Family Nurse Practitioner, NPI 1326401761
Family Nurse Practitioner
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for ANDROMEDA FAIR (CRNP)
240, West 11th Street, West Erie, Erie, Erie County, Pennsylvania, 16501, United States
SUITE 102
ERIE, PA 165011758
Phone: (814) 453-4718
Type: Mailing
3330 PEACH ST STE 106
ERIE, PA 165082771
Phone: (814) 877-8586
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 8 Open Payments records for all available years, with a total value of $161.
Total Amount is formed as General ($161) + Research ($0) + Ownership ($0) = $161.
Last reported payment date: 2023-09-28 • Largest payer in this snapshot: Organon LLC ($36).
Total Amount
$161
General + Research + Ownership
Payments
8
Total payment records
General Amount
$161
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-09-28
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Organon LLC | $36 |
| Bayer Healthcare Pharmaceuticals Inc. | $27 |
| Gilead Sciences, Inc. | $26 |
| ABBVIE INC. | $25 |
| Merck Sharp & Dohme LLC | $24 |
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: 2017-07-26
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20170726001724 | I | Nurse Practitioner | PA | TBD |
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.
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 16501)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | PA | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | PA | |
| - | PA | |
| Nurse Practitioner | PA | |
| - | PA | |
| Nurse Practitioner | PA | |
| Nurse Practitioner | PA | |
| - | PA | |
| - | PA |
Reviews
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