Corey Lee Anderson, PA-C
Individual provider Active NPI Physician Assistant · Rapid City, SD
NPI 1194093161 · NPPES record last updated Jan 16, 2020
Key facts
- NPI
- 1194093161
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 0802 (SD)
- Practice address
- 7220 S Highway 16
Rapid City, SD 57702-8708 - Phone
- (605) 341-1414
- NPI assigned
- Dec 6, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
Merit-based Incentive Payment System (MIPS)
- Final score
- 95.06 of 100
- Quality
- 99.26
- Promoting interoperability
- 90
- Improvement activities
- 40
- Cost
- 92.59
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120210000162 | SD | Practitioner - Physician Assistant | 9436316965 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0802 | SD | Yes |
Addresses
Primary practice location
7220 S Highway 16
Rapid City, SD 57702-8708
Mailing address
PO Box 6850
Rapid City, SD 57709-6850
Phone (605) 737-9144
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2003422 | Medicaid | SD |
Other providers in Rapid City, SD
- Anderson Dental P.C.
- M Brooke Anderson Saunders
- Allison Renee Anderson
- Angela K Anderson
- Ashley Anderson
- Cynthia A Anderson
- Dale R Anderson
- Derek Anderson
- Ellie Anderson
- Gary E Anderson
All providers in Rapid City, SD · Physician Assistant in South Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 16, 2020. 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.