DR. KELLY R ANDERSON DO
NPI 1780670828
General Practice in Vincennes, IN
About Dr. Kelly R Anderson Do NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. KELLY R ANDERSON DO (NPI 1780670828) is an individual general practice provider in Vincennes, Indiana, licensed in Indiana (02001311A) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS, is affiliated with Good Samaritan Hospital, and is a graduate of University Of Kansas School Of Med (kc/wich/sal) (1985).
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Kelly R Anderson Do 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.
Medicare Billing Reassignment
Medicare enrollment records show Kelly Anderson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Vincennes, IN 47591
- Reassigned Medicare billing, Indiana enrollment
- 24 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 3
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.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Good Samaritan Hospital
Acute Care Hospitals · Vincennes, INOther Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
VINCENNES, IN 47591
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 Kelly Anderson's NPI number?
The NPI number for Kelly Anderson is 1780670828. It was assigned to this individual provider in the NPPES registry on September 23, 2005.
Where is Kelly Anderson located?
Kelly Anderson practices at 520 S 7th St, Vincennes, IN 47591. The listed phone number is (812) 885-3810.
What is Kelly Anderson's specialty?
The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.
Is Kelly Anderson enrolled in Medicare?
Yes. Kelly 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.
Which organization bills Medicare for Kelly Anderson's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Kelly Anderson reassigns Medicare benefits to Midwest Emergency Medicine, Inc. (Vincennes, IN). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelly Anderson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Kelly Anderson accept?
Health plans from CareSource list Kelly 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 Kelly Anderson affiliated with any hospitals?
According to CMS data, Kelly Anderson is affiliated with Good Samaritan Hospital.
When was this NPI record last updated?
The NPPES record for Kelly Anderson was last updated on April 20, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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.
# Dr. Kelly R Anderson, DO · NPI 1780670828
General Practice physician in Vincennes, Indiana. Individual provider, active in the CMS NPPES registry since September 23, 2005.
## Identity
- **NPI:** 1780670828 (Entity type: Individual)
- **Enumerated:** September 23, 2005
- **Primary specialty:** General Practice · taxonomy 208D00000X
- **State license:** 02001311A (Indiana)
- **Sole proprietor:** No
## Practice location
- **Address:** 520 S 7TH ST, Vincennes, IN 47591-1038
- **Phone:** (812) 885-3810 · **Fax:** (812) 885-3811
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Midwest Emergency Medicine, Inc. (NPI 1801383278, Vincennes, IN), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Kansas School Of Med, class of 1985
## Record status
- **NPPES last updated:** April 20, 2018
- **Other identifiers:** Medicaid 200022500 (IN); Other 000000110680 (IN)
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Source: [NPI Profile](https://npiprofile.com/npi/1780670828) · Data from the CMS NPPES public registry.