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DR. MARY L ANDERSON DDS
NPI 1831200674
Dentist - General Practice in Maplewood, MN

Active since August 31, 2006PECOS Enrolled
2165 WHITE BEAR AVE, MAPLEWOOD, MN 55109(651) 770-8828(651) 779-1570 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Mary L Anderson Dds NPPES

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

DR. MARY L ANDERSON DDS (NPI 1831200674) is an individual general practice provider in Maplewood, Minnesota, licensed in Minnesota (9871) and active in the NPI registry since August 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1831200674
Entity TypeIndividualFemale
Primary Taxonomy1223G0001X
Provider Legal NameDR. MARY L ANDERSONCredential: DDS
Location Address2165 WHITE BEAR AVEMaplewood, MN 55109
Mailing AddressMail Code 21113a, Po Box 1309Minneapolis, MN 55440-1309 · (952) 883-5151 · Fax (952) 883-5160
Phone(651) 770-8828
Fax(651) 779-1570
Sole ProprietorNo
Enumeration DateAugust 31, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1831200674 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in MN · 9871
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
2165 WHITE BEAR AVE, Maplewood, MN 55109
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Mary L Anderson Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Medicare Billing Reassignment

Medicare enrollment records show Mary Anderson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Group Health, Inc.
Same address
General Practice
2165 WHITE BEAR AVE N
Maplewood, MN 55109
  • Reassigned Medicare billing, Minnesota enrollment
  • 2,274 clinicians in this Medicare group
NPI 1043365208 (651) 770-8828

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55109 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
$85.82 typical visit price
range $56.00 – $168.28
Typical copayment $21.45 (range $14.00 – $42.07)
Most-billed visit code 99203
Established Patient
$69.74 typical visit price
range $18.32 – $138.04
Typical copayment $17.43 (range $4.58 – $34.51)
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.

Other Providers at the Same Location NPPES 5

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

DUANE K HASEGAWA MD
Pediatrics
2165 WHITE BEAR AVE, MAIL STOP 31600A
MAPLEWOOD, MN 55109
Ramsey County (651) 779-1500
MICHELLE A LARSON RD
Dietitian, Registered
2165 WHITE BEAR AVE, MAIL STOP 31600A
MAPLEWOOD, MN 55109
Ramsey County (651) 779-1500
DR. OLOLADE O MAREK DDS
Dentist (General Practice)
2165 WHITE BEAR AVE
MAPLEWOOD, MN 55109
Ramsey County (651) 770-8828
GAIL M AMUNDSON MD
Internal Medicine
2165 WHITE BEAR AVE, MAIL STOP 31600A
MAPLEWOOD, MN 55109
Ramsey County (651) 779-1500
DR. KAREN M RALEIGH DDS
Dentist (General Practice)
2165 WHITE BEAR AVE
MAPLEWOOD, MN 55109
Ramsey County (651) 770-8828

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 Mary Anderson's NPI number?

The NPI number for Mary Anderson is 1831200674. It was assigned to this individual provider in the NPPES registry on August 31, 2006.

Where is Mary Anderson located?

Mary Anderson practices at 2165 White Bear Ave, Maplewood, MN 55109. The listed phone number is (651) 770-8828.

What is Mary Anderson's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Mary Anderson enrolled in Medicare?

Yes. Mary Anderson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Mary Anderson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mary Anderson reassigns Medicare benefits to Group Health, Inc. (Maplewood, MN). 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 Mary Anderson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Mary Anderson was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.