Sean D Anderson, D.O.

Primary specialty

Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X

License

5585387-1204 Issued in UT

Practice address

5405 S 500 E Ste 202
Ogden, UT 84405-7419

Phone

(801) 475-1928

Fax

(801) 475-1808

NPI assigned

Mar 28, 2011

Last updated

Mar 15, 2021By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in ID, UT2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physical Medicine and Rehabilitation

Education

Des Moines University of Osteopathic Medicine and Health Sciences, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Mountainstar Cardiology St Marks LLCGroup PAC ID 2961661855, 42 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ogden Regional Medical Center Hospital, Ogden, UT, CCN 460005
• Ogden Regional Medical Center Inpatient rehabilitation facility, Ogden, UT, CCN 46T005

Merit-based Incentive Payment System (MIPS)

Final score

88.44 of 100Reported as group

Quality

88.05

Promoting interoperability

98

Improvement activities

40

Cost

75.07

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Networks

• UT PPO D-SNP
• UT PPO

Interoperability endpoints

• Direct secure messaging: sean.anderson@hca3.eclinicaldirectplus.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Mountainstar Cardiology St Marks LLC

  dba Heart Center at St Mark's

  • Interventional Cardiology Physician
  • Salt Lake City, UT
  • NPI 1437446168
  Medicare reassignment Care Compare group NPD
• Eirmc Hospitalist Services LLC

  • Internal Medicine Physician
  • Idaho Falls, ID
  • NPI 1144502071
  Medicare reassignment NPD
• Idaho Physician Services Inc.

  dba East Falls Orthopedics

  • Orthopaedic Surgery Physician
  • Idaho Falls, ID
  • NPI 1902841893
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Columbia Ogden Medical Center, Inc.

  dba Ogden Regional Medical Center

  • Rehabilitation Hospital Unit
  • Ogden, UT
  • NPI 1023603214

  Inpatient rehabilitation facility

  Care Compare affiliation
• Columbia Ogden Medical Center, Inc.

  dba Ogden Regional Medical Center

  • General Acute Care Hospital
  • Ogden, UT
  • NPI 1720031636
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1301270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1063701217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741729",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303741729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5405 S 500 E STE 202",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844057419",
            "telephone_number": "801-475-1928",
            "fax_number": "801-475-1808"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3200 Channing Way Ste 306",
            "address_purpose": "LOCATION",
            "city": "Idaho Falls",
            "state": "ID",
            "postal_code": "834047546",
            "country_code": "US",
            "telephone_number": "208-535-4400",
            "fax_number": "208-535-4404",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "SEAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-28",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "ID",
            "license": "O-0868",
            "primary": false
        },
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": "UT",
            "license": "5585387-1204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kory T Anderson, M.D.
• Melody Anderson
• Norman Stillwell Anderson III, PHD
• Peter W Anderson, MD
• Rachel Anderson
• Tamara Anderson, M.S., CCC-SLP
• Tamara Lynn Anderson, PTA
• Tyler Anderson
• Tyler Aldon Anderson
• Vance Anderson

• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Ogden, UT
• Providers in Ogden, UT by specialty
• Sports Medicine (Physical Medicine & Rehabilitation) Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.