JORDAN LILLIAN ANDERSON (PA-C) – Surgical Physician Assistant, NPI 1053066399
Surgical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
8,491 PHYSICIAN ASSISTANT in TX
Provider Addresses for JORDAN LILLIAN ANDERSON (PA-C)
PO BOX 4439
HOUSTON, TX 772104439
Phone: (713) 792-2991
Type: Mailing
1515 HOLCOMBE BLVD
HOUSTON, TX 770304000
Phone: (713) 792-6161
Type: Location
10150 NIAGARA LN N # 100
MAPLE GROVE, MN 553697588
Phone: (224) 213-5886
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 4 Open Payments records for all available years, with a total value of $129.
Total Amount is formed as General ($129) + Research ($0) + Ownership ($0) = $129.
Last reported payment date: 2023-10-19 • Largest payer in this snapshot: GlaxoSmithKline, LLC. ($74).
Total Amount
$129
General + Research + Ownership
Payments
4
Total payment records
General Amount
$129
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-10-19
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| GlaxoSmithKline, LLC. | $74 |
| UCB, Inc. | $30 |
| ImmunoGen, Inc. | $25 |
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: 2023-06-13
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 |
|---|---|---|---|---|
| I20230613002208 | I | Physician Assistant | MN | 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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 14 | 14 | $0 |
Insurance plans in this area (ZIP 77210)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Obstetrics/Gynecology, Gynecological Oncology | MN | |
| Nurse Practitioner | MN | |
| Nurse Practitioner | MN | |
| Physician Assistant | MN | |
| Nurse Practitioner | MN | |
| - | MN | |
| Medical Oncology | MN | |
| Colorectal Surgery (Proctology), General Surgery | MN | |
| Physician Assistant | MN | |
| Physician Assistant | MN |
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