John A Anderson, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

153823 Issued in NY

Practice address

213 Broadway
Port Ewen, NY 12466-7769

Phone

(845) 331-2355

Fax

(845) 331-1184

NPI assigned

May 24, 2006

Last updated

Nov 11, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Mid-Hudson Family Health Institute

  • Family Medicine Physician
  • New Paltz, NY
  • NPI 1326093642
  NPD (past) Authorized official
• The Institute for Family Health

  • Family Medicine Physician
  • Port Ewen, NY
  • NPI 1154695369
  NPD (past)

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415664000000",
    "number": "1114972338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "279 MAIN ST",
            "address_2": "SUITE 204",
            "city": "NEW PALTZ",
            "state": "NY",
            "postal_code": "125611623",
            "telephone_number": "845-255-3046",
            "fax_number": "845-255-0236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 BROADWAY",
            "city": "PORT EWEN",
            "state": "NY",
            "postal_code": "124667769",
            "telephone_number": "845-331-2355",
            "fax_number": "845-331-1184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JOHN",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2014-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "153823",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00849270",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abundant Life Chiropractic a Creating Wellness Center
• Arms Acres, Inc.
• Jill Borner, LCSWR
• Pamela J. Buono, MS,RD,CDN,CDE
• Olivia Francesca Cea, MSW
• Lisa Marie Ciccone, LMSW

• Family Medicine Physician in Port Ewen, NY
• Providers in Port Ewen, NY by specialty
• Family Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.