ELI THEODORE ANDERSON (M.D.) – Psychiatry Physician, NPI 1053342634

ELI THEODORE ANDERSON (M.D.) is a healthcare provider. based in Shenandoah, Texas. specializing in PSYCHIATRY, NEUROPSYCHIATRY. They hold the professional credentials M.D.. They hold a License No. E6214 (TX). The NPI Number for ELI THEODORE ANDERSON (M.D.) is 1053342634

Main info

Male
Sole Proprietor
50 Years Of Experience
Accepts Medicare Assignment
Name
ELI THEODORE ANDERSON (M.D.)
NPI
1053342634
Phone
(713) 714-1399
Address
111 Vision Park Blvd Ste 100
Enumeration Date
5 July 2006
Last Update Date
28 September 2025

Doctor Profile

Medical School Name
BAYLOR COLLEGE OF MEDICINE
Secondary Phone
2815867880
Graduation Year
1976 (50 years ago)
PAC ID
4082603238
Group Practice PAC ID
4789734013
Professional Enrollment ID
I20040511001520
Address ID
TX770903055HO1125XDRXX404
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness85
Years active:19State licenses:1Digital endpointsOther names

2,132 PSYCHIATRY in TX

Provider Addresses for ELI THEODORE ANDERSON (M.D.)

  • 111 Vision Park Blvd Ste 100

    Shenandoah, TX 773843003

    Phone: (713) 714-1399

    Fax: (713) 389-5798

    Type: Location

  • 5500, Guhn Road, Houston, Harris County, Texas, 77040, United States

    HOUSTON, TX 770406161

    Phone:

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 90 Open Payments records for all available years, with a total value of $2,258.

Total Amount is formed as General ($2,258) + Research ($0) + Ownership ($0) = $2,258.

Last reported payment date: 2024-12-17 • Largest payer in this snapshot: ABBVIE INC. ($704).

Total Amount

$2,258

General + Research + Ownership

Payments

90

Total payment records

General Amount

$2,258

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-17

Latest reported date

View all Open Payments →|Open Payments Risk Radar →

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: 2004-05-11

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
I20040511001520IPsychiatryTXTBD

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
99214Established patient office or other outpatient visit, 30-39 minutes7527$0
View full utilization report →

Insurance plans in this area (ZIP 77384)

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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: 4789734013View full group profile
NameSpecialtyState
Nurse PractitionerTX
Nurse PractitionerTX
Nurse PractitionerTX
Nurse PractitionerTX
Nurse PractitionerTX
Nurse PractitionerTX

Reviews

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Frequently asked questions

How is ELI THEODORE ANDERSON (M.D.) identified in CMS data?
CMS-hosted NPPES data lists ELI THEODORE ANDERSON (M.D.) with NPI 1053342634.
Is ELI THEODORE ANDERSON (M.D.) listed as active for patients and plans?
The listing shows ELI THEODORE ANDERSON (M.D.) as active in the NPI system.
What is ELI THEODORE ANDERSON (M.D.)'s specialty?
The listing groups ELI THEODORE ANDERSON (M.D.) with Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Does ELI THEODORE ANDERSON (M.D.) list a practice location?
Patients near Shenandoah, Texas may find ELI THEODORE ANDERSON (M.D.) in results; validate coverage separately.
Why does ELI THEODORE ANDERSON (M.D.) have multiple addresses?
3 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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