Individual provider Active NPI

Jacob Anderson, DO

  • Surgery Physician
  • Montgomery, AL
National Provider Identifier
1184916702
Registry record updated Oct 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
1613 Issued in AL
Practice address
2055 E South Blvd Ste 601
Montgomery, AL 36116-2014
Phone
(334) 747-2999
NPI assigned
May 15, 2011
Last updated
Oct 17, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 1613 AL Primary

Addresses

Primary practice location

2055 E South Blvd Ste 601
Montgomery, AL 36116-2014

Mailing address

301 Brown Springs Rd
Montgomery, AL 36117-7005
Phone (334) 747-4159

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address jaanderson@direct.uabmedicine.org Direct University of Alabama Hospital

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20160728001632 AL Practitioner - General Surgery 9931331683 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2055 E S Blvd
Suite 601
Montgomery, AL 36116-2014
Phone (334) 747-2999

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83 of 100Reported as group
Quality
64.43
Promoting interoperability
100
Improvement activities
40
Cost
78.9

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux14
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1613ALMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs Family Medicine CurrentSince Apr 26, 2022 Accepting new patients
University of Alabama Health Services Foundation, PC. CurrentSince Sep 1, 2016 Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs CurrentSince Apr 26, 2022 Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs Family Medicine Current Accepting new patients
The Health Care Authority for Baptist Health Past Accepting new patients
Health Care Authority for Baptist Health, an Affiliate of Uabhs Past Accepting new patients
The Health Care Authority for Baptist Health an Affiliate of Uabhs Past Accepting new patients
The Health Care Authority for Baptist Health Past Accepting new patients

Locations

1717 6th Ave S
Birmingham, AL 35233
Phone (205) 934-3450

1813 6th Ave S
Birmingham, AL 35233
Phone (205) 934-1180

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

619 19th St S
Birmingham, AL 35249

2055 E South Blvd
Ste 200
Montgomery, AL 36116
Phone (334) 284-5211

2055 E South Blvd
Ste 308
Montgomery, AL 36116
Phone (334) 286-2390

2055 E South Blvd
Ste 601
Montgomery, AL 36116
Phone (334) 281-9000

2055 E South Blvd
Ste 603
Montgomery, AL 36116
Phone (334) 281-9000

301 Brown Springs Rd
Montgomery, AL 36117
Phone (334) 273-4159

Organizations & group practices 8

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1305417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697500800000",
    "number": "1184916702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 BROWN SPRINGS RD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361177005",
            "telephone_number": "334-747-4159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2055 E SOUTH BLVD STE 601",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361162014",
            "telephone_number": "334-747-2999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "JACOB",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-15",
        "last_updated": "2023-10-17",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AL",
            "license": "1613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jaanderson@direct.uabmedicine.org",
            "affiliation": "Y",
            "affiliationName": "University of Alabama Hospital",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1813 6th Ave S",
            "city": "Birmingham",
            "state": "AL",
            "country_code": "US",
            "postal_code": "352331920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.