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ERIK JAMES ANDERSON PA-C
NPI 1164801676
Physician Assistant in South Charleston, WV

Active since May 29, 2015PECOS EnrolledAccepts Medicare Assignment
94.1/100
CMS Quality Rating
242 DIVISION ST, SOUTH CHARLESTON, WV 25309(304) 767-7840(304) 767-7849 Get Directions Write a Review

NPPES record last updated: June 5, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jun 5, 2023, May 2, 2018 (2 updates tracked since 2018).

About Erik James Anderson Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ERIK JAMES ANDERSON PA-C (NPI 1164801676) is an individual physician assistant in South Charleston, West Virginia and active in the NPI registry since May 2015. He is enrolled in Medicare PECOS, is affiliated with Thomas Memorial Hospital, and is a graduate of Other (2015).

NPPES Registry Identity

NPI1164801676
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameERIK JAMES ANDERSONCredential: PA-C
Location Address242 DIVISION STSouth Charleston, WV 25309-1400
Mailing Address415 Morris St, Suite 400Charleston, WV 25301-1842 · (304) 344-3551 · Fax (304) 342-6927
Phone(304) 767-7840
Fax(304) 767-7849
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateMay 29, 2015
Last NPPES UpdateJune 5, 20232 updates tracked since enumeration
NPPES CertifiedMay 25, 2023
✔ NPI 1164801676 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
242 DIVISION ST, South Charleston, WV 25309
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Erik James Anderson Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1052627742
PECOS Enrollment IDI20150825005825
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 9

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
33 services33 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
22 services21 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
21 services20 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
20 services17 patients
Insertion of cage or mesh device to spine bone and disc space during spine fusion 22853
Spine fusion is a procedure to join two or more vertebrae. During this process, a cage or mesh device is inserted into the spine bone and disc space. This helps to stabilize the spine, reduce pain, and improve functionality. The device acts as a bridge for new bone to grow on.
18 services12 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
18 services18 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Thomas Memorial Hospital

Acute Care Hospitals · South Charleston, WV
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number510029
Location4605 Maccorkle Avenue SWSouth Charleston, WV 25309 · Kanawha County
Emergency services Birthing friendly

Princeton Community Hospital

Acute Care Hospitals · Princeton, WV
1/5 CMS rating
OwnershipGovernment - Local
CMS Certification Number510046
Location122 12th StreetPrinceton, WV 24740 · Mercer County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 25309 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$83.49 typical visit price
range $53.20 – $164.59
Typical copayment $20.87 (range $13.30 – $41.14)
Most-billed visit code 99203
Established Patient
$66.84 typical visit price
range $16.47 – $133.29
Typical copayment $16.71 (range $4.11 – $33.32)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

94.1/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality78.46
Promoting Interoperability100
Improvement Activities40

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Erik Anderson's NPI number?

The NPI number for Erik Anderson is 1164801676. It was assigned to this individual provider in the NPPES registry on May 29, 2015.

Where is Erik Anderson located?

Erik Anderson practices at 242 Division St, South Charleston, WV 25309. The listed phone number is (304) 767-7840.

What is Erik Anderson's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Erik Anderson enrolled in Medicare?

Yes. Erik Anderson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Erik Anderson accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, CareSource and Molina Healthcare list Erik Anderson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Erik Anderson affiliated with any hospitals?

According to CMS data, Erik Anderson is affiliated with Thomas Memorial Hospital and Princeton Community Hospital.

When was this NPI record last updated?

The NPPES record for Erik Anderson was last updated on June 5, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.