MRS. JEANETTE MARIA ANDERSON (MD) – Geriatric Medicine (Internal Medicine) Physician, NPI 1104878875
Geriatric Medicine (Internal Medicine) Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
328 FAMILY PRACTICE in WY
Provider Addresses for MRS. JEANETTE MARIA ANDERSON (MD)
4140A Laramie St
Cheyenne, WY 820011969
Phone: (307) 637-2800
Fax: (307) 637-2867
Type: Location
7380 W 52nd Ave Unit 1
Arvada, CO 800023716
Phone: (303) 463-5941
Type: Location
16170, West Dynamite Boulevard, Saguaro Acres, Surprise, Maricopa County, Arizona, 85387, United States
SURPRISE, AZ 853876704
Phone: (623) 640-7116
Type: Mailing
18589, North 59th Avenue, Sunset Vista, Glendale, Maricopa County, Arizona, 85308, United States
STE. 101
GLENDALE, AZ 853081258
Phone: (480) 353-2200
Fax: (480) 353-2201
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: 2015-10-27
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20041006000846 | I | Family Practice | AZ | TBD |
| I20151009001918 | I | Family Practice | WY | TBD |
| I20151027002952 | I | Family Practice | CO | 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 |
|---|---|---|---|---|
| 81003 | Automated urinalysis test | 12 | 12 | $0 |
Insurance plans in this area (ZIP 82001)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | AZ | |
| Physician Assistant | AZ | |
| Nurse Practitioner | AZ | |
| Physician Assistant | AZ | |
| Nurse Practitioner | FL | |
| Nurse Practitioner | AZ | |
| Physician Assistant | AZ | |
| Family Practice | AZ | |
| Nurse Practitioner | AZ | |
| Nurse Practitioner | AZ |
Reviews
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