DR. JOHN EDWARD ANDERSON (DO) – Pediatric Sports Medicine Physician, NPI 1356908552
Pediatric Sports Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for DR. JOHN EDWARD ANDERSON (DO)
2142 N Cove Blvd
Toledo, OH 436063895
Phone: (419) 251-2061
Type: Location
700 Childrens Dr
Columbus, OH 432052664
Phone: (419) 251-2061
Type: Location
West Grand Boulevard, New Center, Detroit, Wayne County, Michigan, 48202:48208, United States
DETROIT, MI 482023026
Phone: (313) 871-3751
Fax: (313) 879-6960
Type: Location
2213 Cherry St
Toledo, OH 436082603
Phone: (419) 251-2061
Type: Location
7640 Sylvania Ave Ste E
Sylvania, OH 435609263
Phone: (419) 251-2061
Type: Location
501 6TH AVE S
ST PETERSBURG, FL 337014634
Phone: (727) 767-3598
Fax: (727) 767-8804
Type: Location
2222 CHERRY ST STE 2000
TOLEDO, OH 436082673
Phone: (419) 251-2061
Type: Mailing
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: 2023-11-30
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20231130000206 | I | Sports Medicine | OH | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 43606)
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