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HELEN ANDERSON FNPC
NPI 1619391364
Nurse Practitioner - Family in Demotte, IN

Active since February 14, 2014PECOS EnrolledAccepts Medicare Assignment
87.95/100
CMS Quality Rating
520 8TH AVE NE, DEMOTTE, IN 46310(219) 987-3581 Get Directions Write a Review

NPPES record last updated: September 10, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Helen Anderson Fnpc NPPES

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

HELEN ANDERSON FNPC (NPI 1619391364) is an individual family provider in Demotte, Indiana, licensed in Indiana (F1113319) and active in the NPI registry since February 2014. She is enrolled in Medicare PECOS, is affiliated with Methodist Hospitals Inc, and is a graduate of Other (2013).

NPPES Registry Identity

NPI1619391364
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameHELEN ANDERSONCredential: FNPC
Location Address520 8TH AVE NEDemotte, IN 46310-9108
Mailing Address7749 W 600 NFair Oaks, IN 47943-8520
Phone(219) 987-3581
Sole ProprietorNo
Medical School CMSOtherGraduated 2013
Enumeration DateFebruary 14, 2014
Last NPPES UpdateSeptember 10, 2020
NPPES CertifiedSeptember 10, 2020
✔ NPI 1619391364 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in IN · F1113319
520 8TH AVE NE, Demotte, IN 46310
Open in Google Maps ↗

Other Names 1

Former Name (1)Helen Hicks

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

Helen Anderson Fnpc 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 ID8921231747
PECOS Enrollment IDI20140501002009
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.

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.
300 services231 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
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.
176 services157 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
130 services130 patients
Urinalysis, manual test 81002
A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.
54 services42 patients
Injection of drug or substance under skin or into muscle 96372
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.
30 services14 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
24 services23 patients

Hospital Affiliations CMS Care Compare 5

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

Methodist Hospitals Inc

Acute Care Hospitals · Gary, IN
1/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150002
Location600 Grant StGary, IN 46402 · Lake County
Emergency services Birthing friendly

St Mary Medical Center Inc

Acute Care Hospitals · Hobart, IN
4/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150034
Location1500 S Lake Park AveHobart, IN 46342 · Lake County
Emergency services Birthing friendly

Northwest Health - Porter

Acute Care Hospitals · Valparaiso, IN
3/5 CMS rating
OwnershipProprietary
CMS Certification Number150035
Location85 East Us Hwy 6Valparaiso, IN 46383 · Porter County
Emergency services Birthing friendly

Community Hospital

Acute Care Hospitals · Munster, IN
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number150125
Location901 Macarthur BlvdMunster, IN 46321 · Lake County
Emergency services Birthing friendly

Franciscan Health Crown Point

Acute Care Hospitals · Crown Point, IN
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number150126
Location12750 Saint Francis DriveCrown Point, IN 46307 · Lake County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46310 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
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
Most-billed visit code 99214
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.

87.95/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored through an Alternative Payment Model
Quality74.04
Promoting Interoperability100
Improvement Activities40

Reported Quality Measures

Breast Cancer Screening
Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer
51%393 patients3/55-star benchmark: 92%
Colorectal Cancer Screening
Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer
47%649 patients3/55-star benchmark: 85%
Diabetes: Eye Exam
Percentage of patients 18-75 years of age with diabetes who had a retinal or dilated eye exam by an eye care professional during the measurement period or a negative retinal exam (no evidence of retinopathy) in the 12 months prior to the measurement period
6%131 patients1/55-star benchmark: 100%
Diabetes: Medical Attention for Nephropathy
The percentage of patients 18-75 years of age with diabetes who had a nephropathy screening test or evidence of nephropathy during the measurement period
70%131 patients3/55-star benchmark: 99%
Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%2,388 patients5/55-star benchmark: 100%
Pneumococcal Vaccination Status for Older Adults
Percentage of patients 65 years of age and older who have ever received a pneumococcal vaccine
67%518 patients3/55-star benchmark: 90%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
29%1,279 patients2/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 100% · 589 patients
Patients tobacco: 14% · 35 patients
84%589 patients4/55-star benchmark: 98%
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 9

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
6 suppliers55 claims121 services$4.37 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
5 suppliers18 claims19 services$0.72 avg. paid by Medicare
Full face mask used with positive airway pressure device, each A7030
DME-Other DME · category DE001N
4 suppliers14 claims14 services$74.50 avg. paid by Medicare
Face mask interface, replacement for full face mask, each A7031
DME-Other DME · category DE001N
3 suppliers12 claims27 services$27.05 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
5 suppliers11 claims11 services$15.58 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
6 suppliers22 claims77 services$1.94 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. BRIAN D SHIELDS M.D.
Dentist (General Practice)
520 8TH AVE NE
DEMOTTE, IN 46310
Jasper County (219) 987-3111
DEMOTTE PHYSICIANS INC.
Family Medicine
520 8TH AVE NE
DEMOTTE, IN 46310
Jasper County (219) 987-3581
MR. JEFFREY GLEN HUXFORD M.D.
Family Medicine
520 8TH AVE NE
DEMOTTE, IN 46310
Jasper County (219) 987-3581
KERI J. SMITH FNP
Nurse Practitioner (Family)
520 8TH AVE NE
DEMOTTE, IN 46310
Jasper County (219) 987-3581

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 Helen Anderson's NPI number?

The NPI number for Helen Anderson is 1619391364. It was assigned to this individual provider in the NPPES registry on February 14, 2014. The provider is also known as Helen Hicks.

Where is Helen Anderson located?

Helen Anderson practices at 520 8th Ave NE, Demotte, IN 46310. The listed phone number is (219) 987-3581.

What is Helen Anderson's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Helen Anderson enrolled in Medicare?

Yes. Helen 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 Helen Anderson accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource list Helen 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 Helen Anderson affiliated with any hospitals?

According to CMS data, Helen Anderson is affiliated with Methodist Hospitals Inc, St Mary Medical Center Inc, Northwest Health - Porter, Community Hospital and Franciscan Health Crown Point.

When was this NPI record last updated?

The NPPES record for Helen Anderson was last updated on September 10, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.