KRISTIAN ANDERSON (AGACNP-BC) – Critical Care Medicine Nurse Practitioner, NPI 1053195099

KRISTIAN ANDERSON (AGACNP-BC) is a healthcare provider. based in Greenfield, Wisconsin. specializing in NURSE PRACTITIONER. They hold the professional credentials AGACNP-BC. They hold a License No. 241106-30 (WI). The NPI Number for KRISTIAN ANDERSON (AGACNP-BC) is 1053195099

Main info

Male
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
KRISTIAN ANDERSON (AGACNP-BC)
NPI
1053195099
Phone
(715) 370-1691
Address
3581 S 51ST ST
Enumeration Date
21 August 2023
Last Update Date
17 October 2023

Doctor Profile

Medical School Name
GEORGETOWN UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
4144537418
Graduation Year
2023 (3 years ago)
PAC ID
0446607584
Group Practice PAC ID
4486026804
Professional Enrollment ID
I20231109003589
Address ID
WI530454199BR19475AVEX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness75
Years active:2State licenses:2Digital endpointsOther names

6,035 NURSE PRACTITIONER in WI

Provider Addresses for KRISTIAN ANDERSON (AGACNP-BC)

  • 3581 S 51ST ST

    GREENFIELD, WI 532201545

    Phone: (715) 370-1691

    Type: Mailing

  • 401 E INDUSTRIAL DR UNIT 627

    HARTLAND, WI 530290820

    Phone: (414) 850-7586

    Type: Location

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: 2023-11-09

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
I20231109003589INurse PractitionerWITBD

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 53220)

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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: 4486026804View full group profile
NameSpecialtyState
Nurse PractitionerWI
Nurse PractitionerWI
Physician AssistantWI
Physician AssistantWI
Nurse PractitionerWI
Pulmonary Disease, Critical Care (Intensivists)WI
Nurse PractitionerWI
Critical Care (Intensivists)WI
Internal Medicine, Internal Medicine, Critical Care (Intensivists), Critical Care (Intensivists)IL
Nurse PractitionerWI

Reviews

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Frequently asked questions

Can I cross-check KRISTIAN ANDERSON (AGACNP-BC) using NPI 1053195099?
NPI 1053195099 belongs to KRISTIAN ANDERSON (AGACNP-BC); compare other details if you need extra assurance.
Is KRISTIAN ANDERSON (AGACNP-BC) shown as active in public data?
Registry records indicate KRISTIAN ANDERSON (AGACNP-BC) maintains an active NPI.
What area of care is associated with KRISTIAN ANDERSON (AGACNP-BC)?
KRISTIAN ANDERSON (AGACNP-BC)'s record emphasizes Critical Care Medicine Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where in Wisconsin is KRISTIAN ANDERSON (AGACNP-BC) registered?
Use Greenfield, Wisconsin as the headline location for KRISTIAN ANDERSON (AGACNP-BC) here.
Does KRISTIAN ANDERSON (AGACNP-BC) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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