Thomas W Andersen, M.D.
Individual provider Active NPI Family Medicine Physician · Lititz, PA
NPI 1073597134 · NPPES record last updated Sep 1, 2007
Key facts
- NPI
- 1073597134
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- MD033956E (PA)
- Practice address
- 562 W 2ND Ave
Lititz, PA 17543-1816 - Phone
- (717) 626-2167
- Fax
- (717) 626-1915
- NPI assigned
- Dec 2, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 12
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Temple University School of Medicine, 1984
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Lancaster General Medical Group
Practice addresses (Care Compare)
3045 Marietta Ave
Lancaster, PA 17601-1321
Phone (717) 299-4644
562 W 2ND Ave
Lititz, PA 17543-1816
Hospital & facility affiliations
- Lancaster General Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal or shaving of skin growth | 1-10 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100330000235 | PA | Practitioner - Family Practice | 3577699594 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lancaster General Medical Group | Family Medicine | Current |
Accepting new patients |
| Lancaster General Medical Group | Current | Accepting new patients | |
| Lancaster General Medical Group | Current |
Accepting new patients | |
| Lancaster General Medical Group | Family Medicine | Past | Accepting new patients |
| Lancaster General Medical Group | Family Medicine | Past | Accepting new patients |
Locations
3045 Marietta Ave
Lancaster, PA 17601
Phone (717) 299-4644
51 Peters Rd
Ste 201
Lititz, PA 17543
Phone (717) 544-6260
562 W 2nd Ave
Lititz, PA 17543
Phone (717) 626-2167
Interoperability endpoints
- tandersen2984@direct-lghealth.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD033956E | PA | Yes |
Addresses
Primary practice location
562 W 2ND Ave
Lititz, PA 17543-1816
Mailing address
562 W 2ND Ave
Lititz, PA 17543-1816
Phone (717) 626-2167
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01463001 | Other | PA | CAPITAL BLUE CROSS |
| 51374 S1QG | Other | PA | GEISINGER HEALTH PLAN |
| C28533 | Other | PA | HEALTH ASSURANCE |
| P002651 | Other | PA | GATEWAY HEALTH PLAN |
| 0010881200004 | Medicaid | PA | |
| 053990 | Other | PA | HIGHMARK BLUE SHIELD |
| 1085320 | Other | PA | AETNA HMO |
| 5491090 | Other | PA | AETNA NON-HMO |
Other providers in Lititz, PA
- Ashley Allis
- Amdent LTD
- American Family Dental Care, P.C.
- Jennifer S Ammons
- Anthony An
- As You Are Counseling Services LLC
- Stephanie Lynn Ashton
- Mary Auker-Endres
- Lesia Aungst
- Cameron David Avery
All providers in Lititz, PA · Family Medicine Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 1, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.