MARK T ANDERSON (MD) – Family Medicine Physician, NPI 1316961659

MARK T ANDERSON (MD) is a healthcare provider. based in Mill creek, Washington. specializing in Family Medicine Physician. They hold the professional credentials MD. They hold a License No. MD00019962 (WA). The NPI Number for MARK T ANDERSON (MD) is 1316961659

Main info

Male
45 Years Of Experience
Accepts Medicare Assignment
Name
MARK T ANDERSON (MD)
NPI
1316961659
Phone
(425) 745-4750
Address
1025 153RD ST SE
Enumeration Date
27 July 2006
Last Update Date
7 December 2017

Doctor Profile

Medical School Name
UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Secondary Phone
4253384000
Graduation Year
1981 (45 years ago)
PAC ID
2062444821
Group Practice PAC ID
8527099456
Professional Enrollment ID
I20050901000422
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for MARK T ANDERSON (MD)

  • 1025, 153rd Street Southeast, Cypress, Mill Creek, Snohomish County, Washington, 98012, United States

    STE 200

    MILL CREEK, WA 980124051

    Phone: (425) 745-4750

    Fax: (425) 745-6158

    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: 2005-09-01

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
I20050901000422IFamily PracticeWATBD

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 98012)

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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: 8527099456View full group profile

Reviews

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Frequently asked questions

Can I verify MARK T ANDERSON (MD) with an NPI only?
You can start verification with NPI 1316961659 for MARK T ANDERSON (MD), then check state licensing separately.
Can I rely on MARK T ANDERSON (MD) being an active provider?
As of the registry snapshot, MARK T ANDERSON (MD) is marked active.
What is MARK T ANDERSON (MD)'s specialty?
The listing groups MARK T ANDERSON (MD) with Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Does MARK T ANDERSON (MD) list a practice location?
Patients near Mill Creek, Washington may find MARK T ANDERSON (MD) in results; validate coverage separately.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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