Lisa M Anderson, MD
Individual provider Active NPI Emergency Medicine Physician · Draper, UT
NPI 1083679989 · NPPES record last updated Mar 19, 2025
Key facts
- NPI
- 1083679989
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Emergency Medicine Physician 207P00000X
- License
- 4842000-1205 (UT)
- Practice address
- 1126 E 12300 S
Draper, UT 84020-9095 - Phone
- (801) 545-0500
- Fax
- (801) 545-0626
- NPI assigned
- Apr 20, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Emergency Medicine
- Education
- University of Utah School of Medicine, 1990
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- After Hours Medical LLC
Practice addresses (Care Compare)
10433 S Redwood Rd
South Jordan, UT 84095-8502
Phone (801) 501-0500
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- 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 |
|---|---|---|---|---|
| I20060119000883 | UT | Practitioner - Emergency Medicine | 7618991456 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4842000-1205 | UT | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| After Hours Medical LLC, Dba Medallus Medical | Emergency Medicine | Current |
Accepting new patients |
| After Hours Medical LLC | Family Medicine | Current | Accepting new patients |
| After Hours Medical LLC, Dba Medallus Medical | Emergency Medicine | Current |
Accepting new patients |
| Emergency Physicians Integrated Care, LLC | Emergency Medicine | Past | Accepting new patients |
Locations
476 N 900 W
Ste C
American Fork, UT 84003
Phone (801) 492-1611
1126 E Draper Pkwy
Draper, UT 84020
Phone (801) 545-0600
10433 S Redwood Rd
South Jordan, UT 84095
Phone (801) 260-1919
10433 S Redwood Rd
#2
South Jordan, UT 84095
Phone (801) 260-1919
Interoperability endpoints
- afterhoursmedical.lisaanderson@154036.advancedmd-direct.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | 4842000-1205 | UT | Yes |
Addresses
Primary practice location
1126 E 12300 S
Draper, UT 84020-9095
Mailing address
10433 S Redwood Rd Ste 2
South Jordan, UT 84095-8502
Phone (801) 260-1919
Other providers in Draper, UT
- Brittney Andersen
- Matthew Todd Andersen
- Alexis M Anderson
- Cheronne Danette Anderson
- Craig W Anderson
- M Brooke Anderson
- Mackenzie Anderson
- Makaylee Anderson
- Michael Anderson
- Michelle Anderson
All providers in Draper, UT · Emergency Medicine Physician in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2025. 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.