Individual provider Active NPI

John Anthony Anderson, MD

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Winter Park, FL
National Provider Identifier
1174841258
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
ME149394 Issued in FL
Practice address
255 N Lakemont Ave Ste 207
Winter Park, FL 32792-3219
Phone
(844) 407-4070
Fax
(407) 743-3050
NPI assigned
May 13, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Reconstructive Orthopaedic Surgery Physician 207XS0114X MD446593 PA
Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X ME149394 FL Primary

Addresses

Primary practice location

255 N Lakemont Ave Ste 207
Winter Park, FL 32792-3219

Mailing address

833 Chestnut St Ste 520
Philadelphia, PA 19107-4430
Phone (609) 677-7003

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NY, FL3 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 3

Enrollment IDStateProvider typePAC IDDetails
I20121011000531 PA Practitioner - Orthopedic Surgery 2961651732 Reassigns benefits to 1 organization
I20180918002022 NY Practitioner - Orthopedic Surgery 2961651732 Reassigns benefits to 1 organization
I20210310002216 FL Practitioner - Orthopedic Surgery 2961651732 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3300 Tillman Dr
FL 2
Bensalem, PA 19020-2071
Phone (215) 642-6900

925 Chestnut St
FL 5
Philadelphia, PA 19107-4206
Phone (267) 339-3500

Merit-based Incentive Payment System (MIPS)

Final score
87.03 of 100Reported as group
Quality
77.92
Promoting interoperability
99
Improvement activities
40
Cost
79.67

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD446593PAMDAdult Reconstructive Orthopaedic Surgery Physician
ME149394FLMDSports Medicine (Orthopaedic Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rothman Orthopaedics of Florida,PLLC CurrentSince Mar 8, 2021 Accepting new patients
Reconstructive Orthopaedic Associates II LLC CurrentSince Sep 1, 2012 Accepting new patients
Rothman Orthopaedics of Florida,PLLC CurrentSince Mar 8, 2021 Accepting new patients
Rothman Orthopaedics of New York, PLLC CurrentSince Aug 1, 2018 Accepting new patients
Rothman Orthopaedics of New York, PLLC CurrentSince Aug 1, 2018 Accepting new patients
Reconstructive Orthopaedic Associates II LLC Adult Reconstructive Orthopaedic Surgery CurrentSince Sep 1, 2012 Accepting new patients

Locations

410 Lionel Way
Ste 201
Davenport, FL 33837
Phone (863) 422-5331

255 N Lakemont Ave
Ste 207
Winter Park, FL 32792
Phone (407) 852-5333

255 N Lakemont Ave
Winter Park, FL 32792
Phone (407) 647-6070

658 White Plains Rd
Tarrytown, NY 10591
Phone (888) 636-7840

118 W Baltimore Ave Ste 302
Media, PA 19063

925 Chestnut St
Fl 5
Philadelphia, PA 19107
Phone (267) 339-3738

833 Chestnut St
Ste 1402
Philadelphia, PA 19107
Phone (267) 339-3543

833 Chestnut St
Ste 520
Philadelphia, PA 19107
Phone (267) 592-6191

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1273708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1174841258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "833 CHESTNUT ST STE 520",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191074430",
            "telephone_number": "609-677-7003",
            "fax_number": "267-339-3761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 N LAKEMONT AVE STE 207",
            "city": "WINTER PARK",
            "state": "FL",
            "postal_code": "327923219",
            "telephone_number": "844-407-4070",
            "fax_number": "407-743-3050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JOHN",
        "middle_name": "ANTHONY",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-13",
        "last_updated": "2022-05-18",
        "certification_date": "2022-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XS0114X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery",
            "state": "PA",
            "license": "MD446593",
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "FL",
            "license": "ME149394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winter Park, FL

Sources for this page

Verify at the official NPI Registry.