CHARLES CHRISTIAN ANDERSON (MD) – Pediatric Cardiology Physician, NPI 1316990666

CHARLES CHRISTIAN ANDERSON (MD) is a healthcare provider. based in Liberty lake, Washington. specializing in PEDIATRIC MEDICINE. They hold the professional credentials MD. They hold a License No. MD00041066 (WA). The NPI Number for CHARLES CHRISTIAN ANDERSON (MD) is 1316990666

Main info

Male
33 Years Of Experience
Accepts Medicare Assignment
Name
CHARLES CHRISTIAN ANDERSON (MD)
NPI
1316990666
Phone
(509) 747-6707
Address
PO BOX 421
Enumeration Date
18 May 2006
Last Update Date
5 April 2021

Doctor Profile

Medical School Name
BAYLOR COLLEGE OF MEDICINE
Secondary Phone
3609330368
Graduation Year
1993 (33 years ago)
PAC ID
0446284467
Group Practice PAC ID
7719899897
Professional Enrollment ID
I20050920000580
Address ID
WA985065080OL200XXNEXX404

Contacts

Secure Messaging
canderson219567@wm.providencedirect.org
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience78
Completeness85
Years active:20State licenses:2Other namesUpdated within 12 months

648 PEDIATRIC MEDICINE in WA

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Provider Addresses for CHARLES CHRISTIAN ANDERSON (MD)

  • 421, Liberty Lane, Evesham Township, Burlington County, New Jersey, 08053-5344, United States

    LIBERTY LAKE, WA 990190421

    Phone: (509) 747-6707

    Type: Mailing

  • Providence Sacred Heart Medical Center and Children's Hospital, 101, West 8th Avenue, Spokane, Spokane County, Washington, 99204, United States

    SUITE 4300

    SPOKANE, WA 992042307

    Phone: (509) 747-6707

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 3 Open Payments records for all available years, with a total value of $154.

Total Amount is formed as General ($154) + Research ($0) + Ownership ($0) = $154.

Last reported payment date: 2024-11-20 • Largest payer in this snapshot: Medtronic, Inc. ($154).

Total Amount

$154

General + Research + Ownership

Payments

3

Total payment records

General Amount

$154

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-20

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Medtronic, Inc.$154
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: 2005-09-20

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
I20050920000580IPediatric MedicineWATBD

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
93296Evaluation of single, dual, multiple lead or leadless pacemaker system or implantable defibrillator system, remote up to 90 days1411$0
View full utilization report →

Insurance plans in this area (ZIP 99019)

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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: 7719899897View full group profile
NameSpecialtyState
Physician AssistantWA
Nurse PractitionerWA
-IL
O P H T H A L M O L O G YOR
O P H T H A L M O L O G YWA
Nurse PractitionerWA
Family PracticeWA
Interventional Radiology, Diagnostic RadiologyOH
Physician AssistantID
Clinical PsychologistWA

Reviews

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Frequently asked questions

What NPI should I save for CHARLES CHRISTIAN ANDERSON (MD)?
Save NPI 1316990666 if you need a stable reference for CHARLES CHRISTIAN ANDERSON (MD).
Is CHARLES CHRISTIAN ANDERSON (MD) active in the national directory?
CHARLES CHRISTIAN ANDERSON (MD)'s public NPI profile is in an active state.
Does CHARLES CHRISTIAN ANDERSON (MD) list a primary specialty?
If you are matching referrals, note Pediatric Cardiology Physician for CHARLES CHRISTIAN ANDERSON (MD). Clinical services aligned with this taxonomy classification.
Does CHARLES CHRISTIAN ANDERSON (MD) practice in Washington?
You will see Liberty Lake, Washington on file for CHARLES CHRISTIAN ANDERSON (MD) alongside any extra practice locations.
What if Liberty Lake, Washington seems incomplete?
Street-level detail can be omitted — open the full address list for this NPI.

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