EDWIN ALEXANDER ANDERS, MD — NPI 1174943617 (Licensed & Credentialed Allopathic & Osteopathic Physicians — Preventive Medicine, Public Health & General Preventive Medicine in TYLER, TX)

CMS-1500 Box 24J / 33a • NPI

1174943617

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

2083P0901X (CMS 84)

Licensed & Credentialed Allopathic & Osteopathic Physicians — Preventive Medicine, Public Health & General Preventive Medicine

Box 32 Service Location & ZIP+4

11937 US HIGHWAY 271, TYLER, TX, 75708-3154

✓ 9-Digit EDI 837 ZIP+4 (75708-3154)

Practice Phone & Referral Fax

(318) 789-7378

Fax: (903) 877-7651

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1174943617 (EDWIN ALEXANDER ANDERS, MD) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1174943617` (NPI-1 Individual Practitioner)
Provider / Legal Name	EDWIN ALEXANDER ANDERS, MD
Plain-English Specialty	Licensed & Credentialed Allopathic & Osteopathic Physicians — Preventive Medicine, Public Health & General Preventive Medicine NUCC Code: `2083P0901X` (Preventive Medicine, Public Health & General Preventive Medicine)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	11937 US HIGHWAY 271, TYLER, TX, 75708-3154
Practice Telephone / Fax	Tel: (318) 789-7378 \| Fax: (903) 877-7651
Administrative Mailing Address	130 DIVISION ST, DERBY, CT, 06418-1326
Enumeration & Last Sync	Enumerated: 2014-04-23 \| CMS Record Updated: 2020-09-14

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

11937 US HIGHWAY 271, TYLER, TX, 75708-3154

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Plain-English Taxonomy & CMS Crosswalk (2083P0901X)

What Does Taxonomy Code 2083P0901X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 2083P0901X translates to:
"Licensed & Credentialed Allopathic & Osteopathic Physicians — Preventive Medicine, Public Health & General Preventive Medicine"

CMS-1500 Medicare Specialty Crosswalk: CMS Code 84 (Physician/Preventive Medicine)
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Preventive Medicine, Public Health & General Preventive Medicine for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (EDWIN ALEXANDER ANDERS, MD)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`390200000X` — Student in an Organized Health Care Education/Training Program Plain English: Licensed & Credentialed Student in an Organized Health Care Education/Training Program	State: N/A \| License: `Verified` \| Primary: Secondary
`2083P0901X` — Preventive Medicine, Public Health & General Preventive Medicine Plain English: Licensed & Credentialed Allopathic & Osteopathic Physicians — Preventive Medicine, Public Health & General Preventive Medicine	State: TX \| License: `S8148` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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EDWIN ALEXANDER ANDERS, MD (NPI #1174943617)