ANDREA J ANDERSON
NPI 1427616986
Nurse Practitioner in Council Bluffs, IA

NPI Status: Active since May 30, 2019

Contact Information

1 EDMUNDSON PL STE 100
COUNCIL BLUFFS, IA
ZIP 51503
Phone: (717) 322-4136
Fax: (717) 322-8129

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  • Individual
  • Female
  • Years of Experience 8
  • Nurse Practitioner
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About ANDREA ANDERSON

This page provides the complete NPI Profile along with additional information for Andrea Anderson, a provider established in Council Bluffs, Iowa with a medical specialization in Nurse Practitioner and more than 8 years of experience. The healthcare provider is registered in the NPI registry with number 1427616986 assigned on May 2019. The practitioner's primary taxonomy code is 363L00000X with license number A154365 (IA). The provider is registered as an individual and her NPI record was last updated 3 years ago.

NPI
1427616986
Provider Name
ANDREA J ANDERSON
Gender
Female
Entity Type
Individual
Location Address
1 EDMUNDSON PL STE 100 COUNCIL BLUFFS, IA 51503
Location Phone
(717) 322-4136
Location Fax
(717) 322-8129
Mailing Address
8632 S 99TH CIR LA VISTA, NE 68128
Medical School Name
OTHER
Graduation Year
2018
Is Sole Proprietor?
No
Enumeration Date
05-30-2019
Last Update Date
02-10-2023
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A nurse practitioner (NP) like Andrea Anderson is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.

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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Nurse Practitioner

Taxonomy Code
363L00000X
Type
Physician Assistants & Advanced Practice Nursing Providers
License No.
A154365
License State
IA
Taxonomy Description
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1363LP0200XPhysician Assistants & Advanced Practice Nursing Providers

Nurse Practitioner
Pediatrics

112780 (NE)

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Complete Silver - EPO
  • Complete Silver + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Elite Bronze - EPO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Gold - EPO
  • Elite Gold + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Everyday Gold - EPO
  • Everyday Gold + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • Choice Bronze HSA - EPO
  • Choice Bronze HSA + Vision + Adult Dental - EPO
  • Clear Gold - EPO
  • Clear Gold + Vision + Adult Dental - EPO
  • Complete Gold - HMO
  • Complete Gold + Vision + Adult Dental - HMO
  • Elite Bronze - EPO
  • Elite Bronze - HMO
  • Elite Bronze + Vision + Adult Dental - EPO
  • Elite Bronze + Vision + Adult Dental - HMO
  • Clear Gold - EPO
  • Clear Gold + Vision + Adult Dental - EPO
  • Complete Gold - EPO
  • Complete Gold + Vision + Adult Dental - EPO
  • Elite Silver - EPO
  • Elite Silver + Vision + Adult Dental - EPO
  • Everyday Bronze - EPO
  • Everyday Bronze + Vision + Adult Dental - EPO
  • Focused Silver - EPO
  • Focused Silver + Vision + Adult Dental - EPO
  • HeartlandBlue Bronze HSA 6500 NEtwork Blue - EPO
  • Elevate by Medica Bronze $0 Copay PCP Visits - EPO
  • Elevate by Medica Bronze Share - EPO
  • Elevate by Medica Expanded Bronze Standard - EPO
  • Elevate by Medica Gold $0 Copay PCP Visits - EPO
  • Elevate by Medica Gold Share - EPO
  • Elevate by Medica Gold Standard - EPO
  • Elevate by Medica Silver $0 Copay PCP Visits - EPO
  • Elevate by Medica Silver Share - EPO
  • Elevate by Medica Silver Standard - EPO
  • Medica Individual Choice Bronze $0 Copay PCP Visits - HMO
  • Bronze Classic - EPO
  • Bronze Classic | with Bryan Health - EPO
  • Bronze Classic 4700 - EPO
  • Bronze Classic Standard - EPO
  • Bronze Classic Standard | with Bryan Health - EPO
  • Bronze Elite + PCP Saver Plus - EPO
  • Bronze Elite + PCP Saver Plus | with Bryan Health - EPO
  • Bronze Simple Diabetes - EPO
  • Bronze Simple Diabetes | with Bryan Health - EPO
  • Gold Classic Standard - EPO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - EPO
  • UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Bronze Copay Focus+ $0 Indiv Med Ded ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - EPO
  • UHC Bronze Essential ($0 Virtual Urgent Care, No Referrals) - EPO
  • UHC Bronze Standard (No Referrals) - EPO
  • UHC Bronze Standard (No Referrals) - HMO
  • UHC Bronze Value ($0 Virtual Urgent Care, No Referrals) - HMO
  • UHC Bronze Value+ ($0 Virtual Urgent Care, Dental + Vision, No Referrals) - HMO
  • UHC Gold Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx, No Referrals) - HMO
  • UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision, No Referrals) - HMO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Andrea Anderson is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Andrea Anderson is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 5991104051

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20210921000714

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

Areas of Expertise

The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.

Administration of chemotherapy into vein, 1 hour or less

Chemotherapy is a treatment that uses drugs to destroy cancer cells. When administered into a vein, it's often through an IV. This procedure usually lasts 1 hour or less. You may feel a slight pinch as the needle is inserted, but it's generally painless.

This service was performed 17 times for 16 patients

Complete blood cell count (red cells, white blood cell, platelets), automated test and automated differential white blood cell count

A Complete Blood Cell Count is a common test that measures various components of the blood, including red cells (carry oxygen), white cells (fight infection), and platelets (help blood clot). An automated test ensures accuracy. The differential count provides detailed information about white cell types.

This service was performed 43 times for 39 patients

Established patient office or other outpatient visit, 20-29 minutes

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.

This service was performed 32 times for 29 patients

Established patient office or other outpatient visit, 20-29 minutes

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.

This service was performed 64 times for 62 patients

Established patient office or other outpatient visit, 30-39 minutes

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

This service was performed 41 times for 36 patients

Infusion into a vein for therapy, prevention, or diagnosis, additional sequential infusion, 1 hour or less

This procedure involves injecting fluids or medication directly into your vein. It's used for treatment, prevention, or diagnosis. An additional sequential infusion may be given within an hour if needed. This helps to ensure the medicine is distributed effectively in your body.

This service was performed 20 times for 11 patients

Injection of drug or substance under skin or into muscle

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

This service was performed 15 times for 13 patients

Insertion of needle into vein for collection of blood sample

This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.

This service was performed 37 times for 32 patients

New patient office or other outpatient visit, 30-44 minutes

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

This service was performed 11 times for 11 patients

Physician Visit Costs



The typical physician office visit costs for Medicare beneficiaries in this area are: $20.46 for a new patient copayment and $23.51 for an established patient copayment.

The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.

For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.

The prices below reflect the costs for new and established patients in the 51503 ZIP code area.

New Patients Visit Costs *

The most utilized procedure code for new patients office visits is 99203

  • Average New Patient Price $81.84
  • Minimum New Patient Price $52.96
  • Maximum New Patient Price $161.4
  • Average New Patient Copayment $20.46
  • Minimum New Patient Copayment $13.24
  • Maximum New Patient Copayment $40.35

Established Patients Visit Costs *

The most utilized procedure code for established patients office visits is 99214

  • Average Established Patient Price $94.05
  • Minimum Established Patient Price $16.91
  • Maximum Established Patient Price $131.98
  • Average Established Patient Copayment $23.51
  • Minimum Established Patient Copayment $4.22
  • Maximum Established Patient Copayment $32.99

* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.

Find Provider Hospital Affiliations - Privileges

Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.

Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Andrea Anderson is affiliated with the following medical facilities:

Hospital Name Address Phone Hospital Type Overall Rating
THE NEBRASKA MEDICAL CENTER987400 NEBRASKA MEDICAL CENTER
OMAHA, NE 68198
(402) 552-2040Acute Care Hospitals
BELLEVUE MEDICAL CENTER, LLC2500 BELLEVUE MEDICAL CENTER DR
BELLEVUE, NE 68123
(402) 763-3600Acute Care Hospitals

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1427616986, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 64. The final step is to find the difference between that total and the next multiple of ten (70 - 64 = 6).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
4
Unchanged
Pos 3
2
Doubled → 4
Pos 4
7
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
1
Unchanged
Pos 7
6
Doubled → 12 → 1 + 2
Pos 8
9
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
6
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 2 → 4 6 → 12 → 3 6 → 12 → 3 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 4 + 4 + 7 + 1 + 2 + 1 + 1 + 2 + 9 + 1 + 6 + 24 = 64

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 64 is 70. The difference is the calculated check digit.

70 - 64 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1427616986.

Other Providers at the Same Location


The following 4 providers are registered at the same or a nearby location.

Internal Medicine (Hematology & Oncology)
1 EDMUNDSON PL STE 100
COUNCIL BLUFFS, IA 51503
Nurse Practitioner
1 EDMUNDSON PL STE 100
COUNCIL BLUFFS, IA 51503
Nurse Practitioner
1 EDMUNDSON PL STE 100
COUNCIL BLUFFS, IA 51503
Nurse Practitioner
1 EDMUNDSON PL STE 100
COUNCIL BLUFFS, IA 51503

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1427616986, enumerated as an "individual" on May 30, 2019.

The provider is located at 1 EDMUNDSON PL STE 100 COUNCIL BLUFFS, IA 51503 and the phone number is (717) 322-4136.

Nurse Practitioner with taxonomy code 363L00000X.

The provider might be accepting Accepts: Ambetter from Home State Health, Ambetter from. Please consult your insurance carrier or call the provider to verify.

Andrea Anderson is affiliated with: THE NEBRASKA MEDICAL CENTER and BELLEVUE MEDICAL CENTER, LLC.